September 28 is National Penicillin Allergy Day, and our allergists want to talk about something we see every day, the penicillin allergy label.
About 10% of people have a penicillin allergy listed in their medical record. However, when people with a reported penicillin allergy are properly evaluated, more than 90% are found not to be allergic and can safely take penicillin.
Resource: aaaai.org
Estimated reading time: 3 minutes
Key Takeaways
- About 10% of people have a penicillin allergy listed in their medical records, but over 90% are not truly allergic after evaluation.
- An inaccurate penicillin allergy label can complicate treatment, leading to the use of broader-spectrum antibiotics that may cause more side effects.
- Delabeling is crucial for better antibiotic care, allowing doctors to use effective first-line therapies.
- Penicillin allergy evaluations involve discussions, possible skin testing, and supervised oral challenges depending on individual history.
- Consider an evaluation for penicillin allergy before needing antibiotics for surgery, pregnancy, or cancer treatment.
Table of contents
How Does a Penicillin Allergy End Up on Your Chart?
There are several reasons a penicillin allergy may appear on your medical record:
- It may never have been a true allergy. Many rashes that occur while taking antibiotics, especially in children, are caused by the infection itself or a viral illness.
- A side effect may have been mistaken for an allergy. Nausea, diarrhea, or a headache can be unpleasant, but they are not allergic reactions.
- The allergy may have faded over time. Even people who once had a true penicillin allergy can lose their sensitivity.
Why Does a Penicillin Allergy Label Matter?
It may seem safer to simply avoid penicillin. However, an inaccurate allergy label can complicate treatment.
When doctors can’t use penicillin, they may need to choose alternative antibiotics that are broader-spectrum, more expensive, or have more side effects. Penicillin allergy labels have also been associated with higher rates of certain infections and antibiotic resistance.
That is why penicillin allergy evaluation and removing an inaccurate label, known as “delabeling,” are important parts of good antibiotic care.
What Does a Penicillin Allergy Evaluation Involve?
The first step is usually a careful conversation about what happened when you took penicillin.
Depending on your medical history:
- You may not need testing if your reaction was not actually an allergy. For example, you may have only experienced an upset stomach.
- Skin testing may be recommended for people with a history suggesting a higher risk of an immediate allergic reaction.
- A supervised oral challenge may follow skin testing. This involves taking a dose of amoxicillin in the office and being monitored afterward. Studies have shown this approach is safe and effective for appropriately selected patients.
Not everyone needs the same test. Your allergist can determine the safest approach based on your individual history.
When Should You Consider an Evaluation?
It is best to sort out a possible penicillin allergy before you urgently need an antibiotic.
An evaluation can be especially helpful before planned surgery, pregnancy and delivery, cancer treatment, or other situations where antibiotics may be important.
Resource: mayoclinichealthsystem.org
Does Your Penicillin Allergy Label Still Belong on Your Chart?
If “penicillin allergy” is on your medical chart, it may be worth taking a second look. An allergist visit can help determine whether you are truly allergic and, if not, safely remove an unnecessary allergy label.
This can help keep effective first-line antibiotic options available when you need them. Think you may have a penicillin allergy? Contact our office to schedule an evaluation with one of our board-certified allergists.