Penicillin allergy skin testing

What do we do now?

Jeremy A. Schafer, Noe Mateo, Garry L. Parlier, John C Rotschafer

Research output: Contribution to journalReview article

12 Citations (Scopus)

Abstract

Drug-induced anaphylaxis remains a relatively infrequent event. However, penicillin and associated β-lactam antibiotics remain a primary cause of anaphylaxis. Penicillin allergies are undoubtedly overreported, and patients with suspected penicillin allergy can be treated with antibiotic alternatives. Penicillin allergy skin testing is a simple and effective way to identify true penicillin allergy. Skin testing involves testing for both major and minor determinants and should be conducted in a facility with available life-support equipment. The commercial major determinant product, benzylpenicilloyl- polylysine, was removed from the market in 2004; this action compromised the ability of clinicians to evaluate a patient's likely response to penicillin therapy. Alternatives to skin testing include laboratory synthesis of major determinants, use of the radioallergosorbent test (RAST), or a combination of RAST and minor determinant skin testing. Patients with suspected penicillin allergy can undergo desensitization if they require penicillin therapy. The planned return of a commercial major determinant will hopefully resolve this issue.

Original languageEnglish (US)
Pages (from-to)542-545
Number of pages4
JournalPharmacotherapy
Volume27
Issue number4
DOIs
StatePublished - Apr 1 2007

Fingerprint

Penicillins
Hypersensitivity
Skin
Radioallergosorbent Test
Anaphylaxis
Anti-Bacterial Agents
Lactams
Polylysine
Equipment and Supplies
Therapeutics
Pharmaceutical Preparations

Keywords

  • Benzylpenicilloyl-polylysine
  • Penicillin allergy
  • PrePen
  • RAST
  • Radioallergosorbent test
  • Skin test

Cite this

Penicillin allergy skin testing : What do we do now? / Schafer, Jeremy A.; Mateo, Noe; Parlier, Garry L.; Rotschafer, John C.

In: Pharmacotherapy, Vol. 27, No. 4, 01.04.2007, p. 542-545.

Research output: Contribution to journalReview article

Schafer, Jeremy A. ; Mateo, Noe ; Parlier, Garry L. ; Rotschafer, John C. / Penicillin allergy skin testing : What do we do now?. In: Pharmacotherapy. 2007 ; Vol. 27, No. 4. pp. 542-545.
@article{a9e43c054e124c389378ad7dab0734a5,
title = "Penicillin allergy skin testing: What do we do now?",
abstract = "Drug-induced anaphylaxis remains a relatively infrequent event. However, penicillin and associated β-lactam antibiotics remain a primary cause of anaphylaxis. Penicillin allergies are undoubtedly overreported, and patients with suspected penicillin allergy can be treated with antibiotic alternatives. Penicillin allergy skin testing is a simple and effective way to identify true penicillin allergy. Skin testing involves testing for both major and minor determinants and should be conducted in a facility with available life-support equipment. The commercial major determinant product, benzylpenicilloyl- polylysine, was removed from the market in 2004; this action compromised the ability of clinicians to evaluate a patient's likely response to penicillin therapy. Alternatives to skin testing include laboratory synthesis of major determinants, use of the radioallergosorbent test (RAST), or a combination of RAST and minor determinant skin testing. Patients with suspected penicillin allergy can undergo desensitization if they require penicillin therapy. The planned return of a commercial major determinant will hopefully resolve this issue.",
keywords = "Benzylpenicilloyl-polylysine, Penicillin allergy, PrePen, RAST, Radioallergosorbent test, Skin test",
author = "Schafer, {Jeremy A.} and Noe Mateo and Parlier, {Garry L.} and Rotschafer, {John C}",
year = "2007",
month = "4",
day = "1",
doi = "10.1592/phco.27.4.542",
language = "English (US)",
volume = "27",
pages = "542--545",
journal = "Pharmacotherapy",
issn = "0277-0008",
publisher = "Pharmacotherapy Publications Inc.",
number = "4",

}

TY - JOUR

T1 - Penicillin allergy skin testing

T2 - What do we do now?

AU - Schafer, Jeremy A.

AU - Mateo, Noe

AU - Parlier, Garry L.

AU - Rotschafer, John C

PY - 2007/4/1

Y1 - 2007/4/1

N2 - Drug-induced anaphylaxis remains a relatively infrequent event. However, penicillin and associated β-lactam antibiotics remain a primary cause of anaphylaxis. Penicillin allergies are undoubtedly overreported, and patients with suspected penicillin allergy can be treated with antibiotic alternatives. Penicillin allergy skin testing is a simple and effective way to identify true penicillin allergy. Skin testing involves testing for both major and minor determinants and should be conducted in a facility with available life-support equipment. The commercial major determinant product, benzylpenicilloyl- polylysine, was removed from the market in 2004; this action compromised the ability of clinicians to evaluate a patient's likely response to penicillin therapy. Alternatives to skin testing include laboratory synthesis of major determinants, use of the radioallergosorbent test (RAST), or a combination of RAST and minor determinant skin testing. Patients with suspected penicillin allergy can undergo desensitization if they require penicillin therapy. The planned return of a commercial major determinant will hopefully resolve this issue.

AB - Drug-induced anaphylaxis remains a relatively infrequent event. However, penicillin and associated β-lactam antibiotics remain a primary cause of anaphylaxis. Penicillin allergies are undoubtedly overreported, and patients with suspected penicillin allergy can be treated with antibiotic alternatives. Penicillin allergy skin testing is a simple and effective way to identify true penicillin allergy. Skin testing involves testing for both major and minor determinants and should be conducted in a facility with available life-support equipment. The commercial major determinant product, benzylpenicilloyl- polylysine, was removed from the market in 2004; this action compromised the ability of clinicians to evaluate a patient's likely response to penicillin therapy. Alternatives to skin testing include laboratory synthesis of major determinants, use of the radioallergosorbent test (RAST), or a combination of RAST and minor determinant skin testing. Patients with suspected penicillin allergy can undergo desensitization if they require penicillin therapy. The planned return of a commercial major determinant will hopefully resolve this issue.

KW - Benzylpenicilloyl-polylysine

KW - Penicillin allergy

KW - PrePen

KW - RAST

KW - Radioallergosorbent test

KW - Skin test

UR - http://www.scopus.com/inward/record.url?scp=34047211173&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34047211173&partnerID=8YFLogxK

U2 - 10.1592/phco.27.4.542

DO - 10.1592/phco.27.4.542

M3 - Review article

VL - 27

SP - 542

EP - 545

JO - Pharmacotherapy

JF - Pharmacotherapy

SN - 0277-0008

IS - 4

ER -