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Overdiagnosis of Penicillin Allergy Leads to Costly, Inappropriate Treatment.

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Argirios Argiriou:
November 13, 2018, JAMA.

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The question is how and where the testing should be done. The gold standard for confirming a penicillin allergy consists of 3 tests in which patients are administered the drug 3 different ways in this order: by a skin prick, an injection, and an oral therapeutic dose. They progress to the second and third tests only if they’re negative on the preceding test. But some people with a positive skin test have no reaction to an oral challenge, whereas some with a negative skin test do.

In a recent article, Eric Macy, MD, an allergist and immunologist at Kaiser Permanente in San Diego, and David Vyles, DO, an assistant professor and pediatric emergency physician at the Medical College of Wisconsin, concluded that an oral challenge is the best way to check whether people labeled penicillin allergic based on a history of low-risk symptoms really are allergic.

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Argirios Argiriou:
15-01-2019

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Argirios Argiriou:
JAMA, January 15, 2019

Evaluation and Management of Penicillin Allergy

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