Are You Really Allergic to Penicillin?

Penicillin is a lifesaving drug, and though it was the first antibiotic ever discovered, it remains a powerhouse of a medication. However, it is also the most-reported drug allergy by Americans. You might not realize that this allergy can be outgrown or that there are different types of reactions to medication.

Thankfully, there is a way to test for penicillin allergy that can open up antibiotic options and avoid higher-priced, more risky alternative medicines. It is always satisfying for me to tell a patient they are not allergic to penicillin after they have lived years, sometimes decades, avoiding it.

About 90 percent of people who think they are allergic to penicillin aren’t, and the more time that it has been since the initial reaction, the less likely that a patient is still allergic. Most people were told they were allergic after a possible reaction in childhood, or they remember an unpleasant experience with medication. Though their symptoms weren’t consistent with a true, life-threatening allergic reaction, they erred on the side of caution and completely avoided the medication thereafter.

Reactions to medications differ, with true allergic reactions being in the minority. They can range from known side effects of penicillin (upset stomach, headache, tongue pain or a delayed rash several days after starting the medications) to a true, life-threatening drug reaction, which may consist of symptoms such as itching, hives, rashes, fever, shortness of breath or swelling in the lips, tongue or face. An allergist can take a proper history, decide which reaction was most likely and give further guidance on how to proceed. Penicillin allergy testing has been extensively studied and standardized, and it is available at some allergist offices.

Healthcare costs have increased due to over reporting of the penicillin allergy. Patients who report being allergic to penicillin are paying more than double the cost of antibiotics than those who don’t. A misdiagnosed penicillin allergy may also result in the use of less appropriate antibiotics. With about 10 percent of Americans believing they have an allergy to penicillin, it’s very important to get tested. Finding out you’re not actually allergic can be life-changing, as penicillin-class antibiotics are used for infections ranging from sinus infections to more severe, life-threatening infections.

If you think you might be allergic to penicillin, get evaluated by an allergist who will test you, if appropriate, and give further guidance. The allergy testing can usually be done in one clinic visit. This procedure allows for the best possible choice of antibiotics, while decreasing drug resistance and side effects of alternative antibiotics. Armed with the right information, you and your doctor can make the best decisions for your healthcare.