Ask the Expert

1/12/2012
I have a 2 yo boy with a history of diffuse rash from augmentin and a less extensive rash with Keflex. He has recurrent ear infections. His PCP recommended Pcn ST. What is the experience skin testing 2 year olds for penicillin?

Thank you for your inquiry.

I am going to forward your inquiry to Dr. Louis Mendelson, who has extensive experience in regards to penicillin skin testing in children. As soon as we hear from Dr. Mendelson, we will forward you his response.

Thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.

We have received a response from Dr. Louis Mendelson. Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

Response from Dr. Louis Mendelson:
Testing for penicillin allergy can be done at any age. I have tested many 2 year old children. The most common cause of reactions at this age are viral infections. I would test with PrePen, Penicillin G and ampicillin. If negative would challenge. Was the reaction to Augmentin hives  or MP rash and how many days into the treatment before the rash appeared. If the reaction was within 2 months unless emergency would wait that long to test and challenge. If need penicillin immediately and reaction within 2 months would test and if negative challenge with omnicef.

Hope this helps. Please let me know how the patient does.

Thanks,
Louis Mendelson