Adena Health Focus July 18, 2019

Allergic to Penicillin?

Ignorance may be bliss, but in the case of penicillin allergies, what you don’t know may be causing you unnecessary health care hassles, risks, and stress. In the case of penicillin being incorrectly listed on people’s lists of allergies — and they are unknowingly not allergic to the antibiotic — this information is contributing to the rise in pharmaceutical prices and the proliferation of antibiotic-resistant microbes. It also increases the likelihood patients will experience undesirable side effects caused by taking penicillin alternatives.

If your medical record says you’re allergic to penicillin, it’s time to get tested. Why? Because there’s a good chance you’re not.

BY THE NUMBERS

Dr. Dana Esham, Adena Allergy and Immunology, says 10 percent of people have penicillin on their allergy list, but nine out of 10 people are not actually allergic.

How does this happen? People are typically diagnosed with penicillin allergies when they are children. A child is prescribed penicillin to treat an infection, and if a rash develops — a common occurrence — penicillin is added to the child’s list of allergies. It is, however, impossible to know with absolute certainty the rash was caused by the penicillin. It could be the infection itself that caused the rash.

“There’s more to consider,” Esham says. “Immune systems change, and with penicillin it’s very likely you will lose that allergy. Up to 50 percent of kids lose a penicillin allergy over five years and 90 percent will lose it over the course of 10 years.”

ANTIBIOTIC STEWARDSHIP

Allergy societies have been encouraging as many people as possible to get tested and potentially get penicillin removed from their allergy lists.

Doing so has benefits across the board. Penicillin is more affordable and has fewer side effects than many other antibiotics. Plus, studies have shown that individuals with penicillin allergies have longer hospital stays and don’t do as well in the hospital as their nonallergic counterparts. This translates to better health outcomes, fewer hassles and lower medical bills.

“If penicillin is not on your allergy list, it gives us more options to treat the infection,” Esham says.

If you go to the hospital with an acute infection that can be helped with penicillin, but the antibiotic is on your allergy list, Esham may be called in to conduct a penicillin allergy test. She often gets referrals from hospitals in efforts to help a patient avoid a hospital stay.

BE PROACTIVE

But why wait until you have an acute infection before getting tested? It would be more useful to and convenient for you to get tested as an outpatient. Penicillin allergies are stressful to patients and make medical care more complicated, costly and risky.

Confirming a penicillin allergy requires a test that takes about two hours. It starts with a two-step skin test, then progresses to graded oral challenges of amoxicillin, all while you’re under observation. If there is any level of reaction the test is aborted, and you know you’re truly allergic.

“Of all the challenges and tests we do, this one is very safe and accurate,” Esham says. “I've tested a range from infancy to the elderly. It’s a relief and delight when they discover they are not allergic. It’s fun to give good news.”

Check your health care plan because getting tested for a penicillin allergy may be covered even if you have a high deductible.

“We all need to be more aware and responsible with our health care,” Esham says. “Physicians can help you with understanding. Get tested.”

If you would like to schedule an appointment with Dr. Dana Esham, call 740-779-4393.