Q:

4/3/2018
What is the currently recommended protocol for evaluation of a vague history of penicillin allergy (most likely a viral exanthema without a history of systemic symptoms)?

A:

Penicillin G 10,000 u/cc and Prepen FS prick with positive and negative controls. If negative after 15 mins, doses above ID with positive and negative controls. A positive test is prick/ID wheat greater than or equal to 3 mm greater than saline control. If negative after 15 mins, challenge to the age appropriate dose of the penicillin to which the patient reacted and observe for 1 hour.

Joint Task Force on Practice Parameters, American Academy of Allergy, Asthma and Immunology, American College of Allergy, Asthma and Immunology, Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol 2010; 105:259.

Patricia McNally, MD, FAAAAI

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