The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy.
@article{Salkind2001TheRC, title={The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy.}, author={Alan R. Salkind and Paul G. Cuddy and John W. Foxworth}, journal={JAMA}, year={2001}, volume={285 19}, pages={ 2498-505 } }
CONTEXT
Clinicians frequently withhold antibiotics that contain penicillin based on patients' self-reported clinical history of an adverse reaction to penicillin and the clinicians' own misunderstandings about the characteristics of a true penicillin allergy.
OBJECTIVES
To determine the likelihood of true penicillin allergy with consideration of clinical history and to evaluate the diagnostic value added by appropriate skin testing.
DATA SOURCES
MEDLINE was searched for relevant English…Â
205 Citations
The Cost of Self-Reported Penicillin Allergy: A Systematic Review.
- MedicineThe journal of allergy and clinical immunology. In practice
- 2018
Clinical history as a predictor of penicillin skin test outcome.
- MedicineAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
- 2006
Utility of penicillin allergy testing in patients presenting with a history of penicillin allergy
- MedicineAsia Pacific allergy
- 2013
A minority of patients presenting with a history of penicillin allergy have evidence of immune-mediated hypersensitivity in this study, demonstrating the usefulness and discriminating power of objective testing, which must include three-day oral challenge.
Penicillin skin testing in the evaluation and management of penicillin allergy.
- Medicine, BiologyAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
- 2011
Patient and Primary Care Physician Perceptions of Penicillin Allergy Testing and Subsequent Use of Penicillin-Containing Antibiotics: A Qualitative Study.
- MedicineThe journal of allergy and clinical immunology. In practice
- 2019
Patient and Prescriber Views of Penicillin Allergy Testing and Subsequent Antibiotic Use: A Rapid Review
- MedicineAntibiotics
- 2018
Clinicians and patients need to be supported to use PAT services and equipped with the skills to use penicillins appropriately following a negative allergy test result, and lack of awareness and knowledge of PAT services by both clinicians and patients is suggested.
A clinical decision-making algorithm for penicillin allergy
- MedicineAnnals of medicine
- 2017
A clinical algorithm based on the patient’s clinical history of the supposed allergic event to penicillin misclassified 3/41 truly allergic patients cannot recommend the use of this algorithm in general practice, however, it can be useful in emergency situations in hospital settings.
Assessing Use of a Standardized Allergy History Questionnaire for Patients with Reported Allergy to Penicillin.
- MedicineThe Canadian journal of hospital pharmacy
- 2021
Background
Inappropriate allergy labelling is associated with significant clinical and pharmacoeconomic implications. Detailed antimicrobial allergy assessments represent a key component of…
A real-time prospective evaluation of clinical pharmaco-economic impact of diagnostic label of ‘penicillin allergy’ in a UK teaching hospital
- MedicineJournal of Clinical Pathology
- 2014
Obtaining a structured history from the patient and family physician alone can enable an accurate identification of penicillin allergy status and total acquisition cost of second-line antibiotics is higher than if these patients were prescribed first- line antibiotics.
Clinical and genetic risk factors of self-reported penicillin allergy.
- Medicine, BiologyThe Journal of allergy and clinical immunology
- 2008
References
SHOWING 1-10 OF 58 REFERENCES
Allergy to penicillin: fable or fact?
- MedicineBMJ
- 1991
Most patients who gave a history of penicillin allergy are not so allergic, and their actual allergic state should be substantiated whenever feasible, and for patients reporting minor or vague reactions negative findings with a radioallergosorbent test to phenoxymethylpenicillin and benzylPenicillin provide sufficient evidence to give oral penicillian safely.
A perspective on penicillin allergy.
- MedicineArchives of internal medicine
- 1992
The current and past literature was reviewed in an attempt to develop practical treatment approaches and to identify clinical questions that need further investigation related to penicillin allergy.
Risk of administering cephalosporin antibiotics to patients with histories of penicillin allergy.
- Medicine, BiologyAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
- 1995
Data indicate that it is safe to administer cephalosporin antibiotics to penicillin-allergic patients andPenicillin skin tests do not identify potential reactors, and post-marketing studies of second and third generation cep Halosporins showed no increase in allergic reactions in patients with penicillillin allergy histories.
Penicillin skin testing: a way to optimize antibiotic utilization.
- Medicine, BiologyThe American journal of medicine
- 1999
The role of skin testing for penicillin allergy.
- MedicineArchives of internal medicine
- 1992
To the Editor.— We believe that a recent article by Redelmeier and Sox 1 has left readers with an erroneous perception regarding the utility of penicillin skin testing. Redelmeier and Sox state that…
Diagnosis of penicillin allergy by skin testing: the Manitoba experience.
- MedicineCanadian Medical Association journal
- 1978
Of 169 patients reacting negatively to skin testing who received a specific drug challenge only 2 manifested mild urticaria; this indicates the reliability of the skin tests in predicting penicillin allergy.
Prediction of penicillin allergy by immunological tests.
- MedicineAnnals of the New York Academy of Sciences
- 1967
Routine elective penicillin allergy skin testing in children and adolescents: study of sensitization.
- MedicineThe Journal of allergy and clinical immunology
- 1984
Immediate hypersensitivity reactions to penicillin and related antibiotics
- Medicine, BiologyClinical allergy
- 1988
Allergenicity of penicillins is the major clinical problem that precludes the use of this class of antibiotics in a significant portion of the general population who are believed to be sensitive.
Penicillin allergy: anti-penicillin IgE antibodies and immediate hypersensitivity skin reactions employing major and minor determinants of penicillin.
- MedicineArchives of disease in childhood
- 1980
It was concluded that penicillin allergy is often overdiagnosed and the diagnosis can be reliably confirmed by skin tests using major and minor determinants of benzylpenicillin and by the radioallergosorbent test; such hypersensitivity is not permanent.