OBJECTIVE: To assess whether, on the basis of one blood test, penicillin allergy might be excluded sufficiently for general practitioners to give oral penicillin to patients claiming a history of penicillin allergy. DESIGN: Prospective study of patients referred by general practitioners. SETTING: Outpatient allergy clinic in a district general hospital. PATIENTS: 175 referred patients who gave a history of immediate type reaction to penicillin, of whom 144 attended as requested and 132 completed the investigations. MAIN OUTCOME MEASURES: History and examination, serum radioallergosorbent test to phenoxymethylpenicillin and benzylpenicillin, and oral challenge with penicillin. RESULTS: Of 132 patients, four were confirmed to have penicillin allergy by the radioallergosorbent test and 128 had an oral penicillin challenge without ill effect. CONCLUSIONS: Most patients who gave a history of penicillin allergy are not so allergic, and their actual allergic state should be substantiated whenever feasible. For patients reporting minor or vague reactions negative findings with a radioallergosorbent test to phenoxymethylpenicillin and benzylpenicillin provide sufficient evidence to give oral penicillin safely.
OBJECTIVE: To assess whether, on the basis of one blood test, penicillinallergy might be excluded sufficiently for general practitioners to give oral penicillin to patients claiming a history of penicillinallergy. DESIGN: Prospective study of patients referred by general practitioners. SETTING:Outpatientallergy clinic in a district general hospital. PATIENTS: 175 referred patients who gave a history of immediate type reaction to penicillin, of whom 144 attended as requested and 132 completed the investigations. MAIN OUTCOME MEASURES: History and examination, serum radioallergosorbent test to phenoxymethylpenicillin and benzylpenicillin, and oral challenge with penicillin. RESULTS: Of 132 patients, four were confirmed to have penicillinallergy by the radioallergosorbent test and 128 had an oral penicillin challenge without ill effect. CONCLUSIONS: Most patients who gave a history of penicillinallergy are not so allergic, and their actual allergic state should be substantiated whenever feasible. For patients reporting minor or vague reactions negative findings with a radioallergosorbent test to phenoxymethylpenicillin and benzylpenicillin provide sufficient evidence to give oral penicillin safely.
Authors: David Vyles; Asriani Chiu; John Routes; Mariana Castells; Elizabeth J Phillips; Jennifer Kibicho; David C Brousseau Journal: Pediatrics Date: 2018-05 Impact factor: 7.124
Authors: Ali S Raja; Christopher J Lindsell; Jonathan A Bernstein; Christopher D Codispoti; Joseph J Moellman Journal: Ann Emerg Med Date: 2009-02-13 Impact factor: 5.721