Services & Specialties March 16, 2021

Penicillin Testing

Penicillin: Not a Villain

Board-certified allergists and immunologists Rekha Raveendran, MD and Dana Esham, MD, are well familiar with the treatment of seasonal allergies. Dr. Esham is the Medical Director for ENT and Allergy and has been with Adena for over nine years. Dr. Raveendran joined Adena in 2020 after having worked at The Ohio State University and in private practice. They both enjoy their work at Adena where the “inclusive, welcoming environment allows for more collaboration and great patient care.”

Are You Sensitive?

Dr. Raveendran and Dr. Esham have noticed a concerning trend. It’s the trend to move away from common penicillin-based prescriptions, like Amoxicillin and Augmentin, in favor of other antibiotics secondary to many patients having a history of penicillin allergy.

“Part of what the medical community sees happening is that people’s medical records have them marked as having a penicillin allergy, when that is not the case,” says Dr. Raveendran. “They may have had a rash when they were younger that was thought to be a reaction to penicillin, but wasn’t, or they did have an allergy, but at this point no longer have a sensitivity to penicillin.” The result is that many people are thought to have a penicillin allergy which leads them to taking alternative antibiotics that are more expensive, possibly less effective and more likely to cause antibiotic resistance.

Penicillin is Your Friend, Don’t Resist It

According to the Centers for Disease Control and Prevention (CDC), about 10% of the U.S. population reports a penicillin allergy but <1% of the whole population is truly allergic.  And approximately 80% of patients with  a penicillin allergy lose their sensitivity after 10 years.1  We would like for penicillin allergic patients to be aware that they have a 90% chance of not being allergic now.  We recommend to contact Adena Allergy to get penicillin tested.” says Dr. Raveendran. “That way, if we can take penicillin off of their allergy list, they can take a penicillin-based antibiotic which is likely more effective, less expensive, have less side-effects and reduce the risk of contributing to these resistant ‘super-bugs’ we hear about.”

Antibiotic resistance happens when germs and bacteria develop the ability to resist the drugs intended to kill them, hence the nickname of “super-bug.” That means the germs can continue to grow and cause infection. In many cases, antibiotic-resistant infections require extended hospital stays, additional follow-up doctor visits, and more costly, and potentially more severe side effects.

Penicillin Can Make a Diff-erence

“One of the biggest concerns, especially for patients admitted to the hospital, is that some antibiotics are more prone to cause you to develop C. difficile, or C. diff,” says Dr. Esham. C. diff is a dangerous, highly contagious bacteria that can cause severe diarrhea and colitis [an inflammation of the colon] and can possibly lead to death if not treated aggressively. “With penicillin-type medications, patients have less of a risk of acquiring C. diff,” says Dr. Esham. “Penicillin based antibiotics are generally well tolerated while some of the alternatives can have more severe side effects.”

Patients who have or suspect they have a penicillin allergy can contact Adena Allergy and Immunology at 740-779-4393 or visit Adena.org to schedule an appointment online. Dr. Raveendran and Dr. Esham can initially screen patients using a virtual visit or an in office visit to make sure a penicillin -test is appropriate. If a patient is a good candidate, they would next come to the Adena offices for a simple penicillin allergy skin test. The test usually takes two hours, so that the Adena team can carefully monitor any potential negative reactions. If there are no reactions, the patient will no longer be penicillin allergic, and that can benefit the patient with more and potentially better options for fighting infections.

 

1 Centers for Disease Control and Prevention. Evaluation and Diagnosis of Penicillin Allergy for Healthcare Professionals. Atlanta, GA: Centers for Disease Control and Prevention, 2017. https://www.cdc.gov/antibiotic-use/community/for-hcp/Penicillin-Allergy.html