Are all Penicillin Allergies in Children Real ?

Authors:Nicola M. Parry, DVM; CME Author: Charles P. Vega, MD
Medscape Clinical briefs 8/4/2017

Allergy to penicillin is 1 of the most common drug allergies encountered by clinicians, and the presence of penicillin allergy can significantly change prescribing patterns. This may result in the application of broad-spectrum antibiotics for common infections amenable to treatment with beta-lactam antibiotics.

The vast majority of patients with penicillin allergy never receive formal testing, in part because the gold standard for testing for penicillin allergy is laborious. 

• Standard testing for penicillin allergy begins with a percutaneous skin test, followed by a second test at the more sensitive intracutaneous layer, and concludes with an oral drug challenge. Previous research has found that more than 90% of adults with penicillin allergy presenting to the ED had a negative result on skin testing.
• The current study suggests a 17-item questionnaire completed by parents of children with a history of penicillin allergy can successfully identify children with a low risk for true allergy.
• Implications for the Healthcare Team: Every new entry added to a patient's list of medication allergies is usually present for a very long time. The current study suggests we should look at the list of medication allergies more critically to avoid limiting therapeutic options for patients.