Penicillin Allergy Skin Testing: What Do We Do Now?

  title={Penicillin Allergy Skin Testing: What Do We Do Now?},
  author={Jeremy A Schafer and Noe Mateo and Garry L Parlier and John C. Rotschafer},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
Drug‐induced anaphylaxis remains a relatively infrequent event. However, penicillin and associated β‐lactam antibiotics remain a primary cause of anaphylaxis. Penicillin allergies are undoubtedly overreported, and patients with suspected penicillin allergy can be treated with antibiotic alternatives. Penicillin allergy skin testing is a simple and effective way to identify true penicillin allergy. Skin testing involves testing for both major and minor determinants and should be conducted in a… 
Penicillin Allergy: Value of Including Amoxicillin as a Determinant in Penicillin Skin Testing
A retrospective review of inpatient PST results from 1995 to 2007 indicates that the inclusion of the amoxicillin determinant appears to identify a small but important group of allergic individuals who may otherwise test negative on a PST panel.
Antibiotic Skin Testing in the Intensive Care Unit: A Systematic Review.
Introduction of a standardized skin test for all antibiotics in intensive care unit patients to help select the most appropriate antibiotic treatment regimen might help save lives and reduce costs.
Allergic Cross-Sensitivity Between Penicillin, Carbapenem, and Monobactam Antibiotics: What are the Chances?
Although variability in cross-reactivity rates between β-lactam classes exists in the literature, the practice of avoiding carbapenems in penicillin-allergic patients should be reconsidered.
Antibiotic Allergy: A Clinical Review
Management of antimicrobial hypersensitivity follows specific considerations in function of the type of allergic reaction and antibiotic class.
Treatment of a proven antibiotic allergy may include avoidance, but because the ICU patient frequently harbours an organism that has multiple antibiotic resistance patterns and demands use of a drug despite suspected allergy, methods of desensitisation should be known.
Safety of Meropenem in Patients Reporting Penicillin Allergy: Lack of Allergic Cross Reactions
This is the first prospective clinical study demonstrating that meropenem may be safely given to patients with known/unknown allergic reactions to Penicillin, including those with anaphylactic reactions, without penicillin skin testing.
An update on adverse drug reactions related to β-lactam antibiotics
ABSTRACT Introduction: β-lactams have been consistently associated with the majority of drug-related adverse events. Generally, these are mild under proper dosing and judicious selection. Areas
Immediate‐type hypersensitivity drug reactions
There is an urgent need to improve and standardize diagnostic testing and desensitization protocols as other diagnostic tests currently available for assessment of immediate drug allergy are not highly predictive.


Diagnosis and management of penicillin allergy.
The role ofPenicillin skin testing for evaluating penicillin allergy and the use of cephalosporin in patients with a history of peniillin allergy is reviewed.
Questionable history of immediate-type hypersensitivity to penicillin in Staphylococcal endocarditis: treatment based on skin-test results vers-us empirical alternative treatment--A decision analysis.
  • P. Dodek, P. Phillips
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 1999
Whether utility, cost, or average cost-utility was the outcome of interest, skin-testing was preferred to no skin- testing in most conditions.
Antigen-specific desensitization of patients allergic to penicillin.
  • T. Sullivan
  • Medicine, Biology
    The Journal of allergy and clinical immunology
  • 1982
Clinical practice. Antibiotic allergy.
Although allergic reactions to antibiotics account for only a small proportion of reported adverse drug reactions, they are associated with substantial morbidity and mortality and increased health
Proving penicillin allergy.
The full spectrum of allergic, immune, and nonimmune reactions to penicillin is described and how to assess and treat patients with suspectedPenicillin allergy is discussed.
Clinical patterns and results of radioallergosorbent test (RAST) and skin tests in penicillin allergy
Some patients with positive skin tests to benzylpenicillin and penicilloic acid did not have detectable circulating IgE antibodies to BPO, emphasizing the need for including these antigens in in vitro methods.