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Did you know that 9 out of 10 people who think they are allergic to penicillin can actually take penicillin safely?
Penicillins, including amoxicillin, are our best antibiotics and are used to treat many infections caused by bacteria in children and adults. That’s why we offer penicillin allergy testing, to explore whether it might be safe for you to remove your penicillin allergy label in your chart.
What is a penicillin allergy?
Some people may develop a reaction to penicillins or other antibiotics closely related to penicillin. These reactions can range from a mild rash to rare life-threatening allergic reactions.
But most reactions are actually mild side effects of the medication or infection itself and are not dangerous. They do not mean someone is allergic to penicillin.
Why is it important to test for penicillin allergies and remove incorrect allergy labels?
We care about testing for and removing incorrect penicillin allergy labels because we want the best care for you. Penicillins are the recommended treatment (doctors call this “first line therapy”) for many common bacterial infections because they are the most effective.
When someone is incorrectly labelled as having a penicillin allergy, doctors need to use second-line antibiotics. Second-line antibiotics can be less effective, cost more and have more side effects. They can also increase the risk of diseases that are resistant to antibiotics.
It is important to identify and label true allergies, but it is also important to ensure that people - especially children - who can take penicillin safely are not incorrectly labelled with a penicillin allergy. This is to make sure that everyone gets the best care for them.
How do we test for penicillin allergies?
The current recommendations suggest that your care team can check your reported symptoms and medical history against current evidence and make a decision about removing your penicillin allergy from your chart. But we know this process can make many patients and caregivers anxious, and that doing a penicillin allergy test beforehand is an important step to give reassurance!
The best way to test penicillin allergies is called the penicillin or amoxicillin challenge. Just like many other allergy tests, this means giving a very small dose of the antibiotic in a supervised setting to see if an allergic reaction occurs.
Being in a hospital is the safest place to do this penicillin challenge. Only patients who are at the lowest risk for a reaction are tested.
How does the care team determine who is in the low-risk category?
You may fall into the low-risk category if you have had:
- a mild reaction to penicillin that did not require medical care (i.e. did not have to visit an emergency department, be treated with epinephrine, or be admitted to hospital)
- a mild symptoms, including skin rash, that appeared more than one hour after taking the medication
- headache, diarrhea, vomiting or abdominal pain as the only symptoms
- side effects that occurred more than 10 years ago
- a reported family history of penicillin allergy, but have not had a reaction yourself
If you have this type of low-risk medical history, then you're an excellent fit for the penicillin challenge!
Here's what to expect during the challenge:
- Before the challenge starts your care provider will make sure that precautions are in place, just in case you have a reaction.
- You will receive one dose of a penicillin, either in an oral form (called amoxicillin) or IV form (called ampicillin).
- You will stay for 30-60 minutes, with your care provider observing you in case of a reaction.
If you show any signs or symptoms of an allergic reaction, you will immediately be assessed and if necessary, treated with the right medications to help.
If you don't show any signs or symptoms of an allergic reaction, this means you have successfully passed the penicillin challenge! Your care team will remove the penicillin allergy label from your medical chart. They will also give you a document that you can bring to your family doctor and pharmacy so that your records can be updated there, too.
Questions?
If you have any questions or concerns, please reach out to your care team to discuss.