Published Online: July, 2014
Penicillin allergy is one of the most common drug allergies reported by patients. However, many of these patients do not show any evidence of actually having a penicillin allergy when tested with a skin test. Hence, many patients avoid penicillin unnecessarily, receive more expansive antibiotics, and therefore have higher chances of developing antibiotic resistant bacteria. Studies have shown penicillin skin testing to be an effective diagnostic tool in the evaluation of penicillin allergy in adults; however, it has not been well studied in children.
In a study recently published in The Journal of Allergy and Clinical Immunology: In Practice, Fox and colleagues showed that penicillin skin testing is also a safe and effective diagnostic tool in the evaluation of penicillin allergy in children. In the study, 778 children with a history of penicillin allergy underwent penicillin skin testing, and some underwent an oral challenge with penicillin if the skin test was negative.
Like adults, most children with a history of penicillin allergy who underwent the skin test were negative (90%). Only 8.5% of the children showed evidence of a penicillin allergy with the skin test. Among those who took penicillin after a negative penicillin skin test, only 3.8% had a reaction. No children developed a reaction to the penicillin skin test.
A penicillin skin test is a safe and effective means of evaluating children with a history of penicillin allergy.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.