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March 23, 2009

Am I really allergic to penicillin?

Posted: 03:24 PM ET

By Miriam Falco
CNN Medical News Managing Editor

About 20 years ago, when I was barely out of college and a struggling journalist, I developed a horrible sore throat. I didn't have a regular doctor, so I had my throat examined in a small clinic in a strip mall. The doctor figured I had strep throat, but the test came back negative. Still, she prescribed antibiotics and sent me on my way. The next morning, I woke up with little red dots all over my body, so I went back to the clinic. The same doc looked at me, said I had hives, harrumpfed that I was allergic to penicillin and gave me a prescription for a different antibiotic. The sore throat eventually went away, but every time since that I've gone to a doctor or dentist and I’ve listed penicillin as one of my allergies. Still, I always wondered if I really had an allergy; I took penicillin frequently during my childhood and never had an allergic reaction.

I came across a recent study published in the Annals of Emergency Medicine that said 80 to 90 percent of people who report being allergic to penicillin are really not.

This new study sought to determine how many patients who came into an Emergency Department (ED) and said they are allergic to penicillin really were allergic. Using two back-to-back skin tests, doctors in the ED at the University of Cincinnati tested 150 patients who reported having a penicillin allergy. 91 percent of these patients tested negative for the allergy.

For Dr. Joseph Moellman, an associate professor at the University of Cincinnati Department of Emergency Medicine, who conducted this study, finding out that taking the additional 30 minutes to conduct these two tests has several important implications. "We see a lot of patients with pneumonia, with sepsis, for which penicillin is a great drug...It's also a lot cheaper." Moellman says the average cost saving is $71. So if, for example, a pneumonia patient is in the hospital for a week, and possibly needs antibiotics every six hours – significant savings can add up very quickly. Plus, using penicillin where it's known to work allows doctors to save the few newer antibiotics we have for illnesses that have become resistant to penicillin.

"This is good information," says Dr. Clifford Bassett, an allergy expert and spokesperson for the American Academy for Allergy, Asthma and Immunology. "The fact that the test is fast and inexpensive is helpful." But he did point out that there has been a shortage of proper testing agents for penicillin. Once these testing agents become more widely available again, Bassett says that this test could be done in other settings too, not just in an emergency room, but also in a regular doctor's practice.

He adds that some previous research suggests that some people who genuinely were allergic to penicillin could lose their allergy if they don't come in contact with this drug for 10 years or more.

Of course neither doctor could explain whether I really am allergic to penicillin. But Moellman explained that sometimes a virus itself can cause hives, and Bassett told me that usually it takes more than 24 hours for a penicillin allergy to become evident. I, for one, plan to get tested to determine whether I truly am allergic to penicillin.

Have you been told you're allergic to penicillin? Would you consider getting tested?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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Filed under: Allergies • Health


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Michael Stanley French   March 23rd, 2009 18:53 ET

I took penicillin in my late teens and my hip swelled up as big as a basketball and was so tight I could not bend over. I was told that I was allergic to it and I have listed that on all of my medical papers all these years. I am now 58 and am wondering if I really am allergic or was all these years. Yes I would consider getting tested. Please tell me what do I ask my doctor how to proceed with this.

Nancy   March 24th, 2009 06:50 ET

When I was around 6 yrs old I was given penicillin and sulpha
and went into shock. Later when I was in my 30's I went into shock
with hydrodiuril (contains sulpha)- one pill only. Not going to test out if it is penicillin or not when I was a child. Too risky.

Ohio Betty   March 24th, 2009 11:08 ET

When I was 9, I had to take liquid penicillin over a long period of time ("long" in kid terms ... maybe a couple months??) because of a bout of pneumonia.

One afternoon, I broke out in a terrible case of hives, which our pediatrician attributed to the penicillin. He said my body had developed an intolerance to it, and I shouldn't have penicillin again.

That was 36 years ago. I'd love to be tested to see if I'm allergic now.

I haven't been on an antibiotic since some sinus surgery four years ago, but it would be nice to know I could use penicillin for exactly the reasons mentioned (cost and preserving other antibiotics for penicillin-resistant problems).

Judy Griffing   March 24th, 2009 11:11 ET

I have been told that I am allergic to penicillin. I would like to get tested but I don't know where to go.

DB   March 24th, 2009 12:32 ET

I've been diagnosed as being allergic to sulfa. Unfortunately, that allergy is probably real, since I felt gradually worse for days after taking the medication twice in four years for an infection. At a week after the medication was started the second time, I was feverish, fatigued, and only then just beginning to show a petiechiae style rash all over the body. My eosinophil count (normally between 0 and 3 %) was 13.4%. I'd be willing to be skin tested to see if it's still an active allergy.

On the other hand, I worked with a lot of patients when I was in an ED. Conversations often went like this:

Me "Are you allergic to any medications?"

Patient "Yes, antibiotic X"

"What happens when you take antibiotic X?"

"I get stomach cramps and bad diarrhea."

"Umm...that's not an allergy, that's an unpleasant side effect."

A lot of patients don't know the difference between allergies and side effects, and those fine-print inserts only help a little and take a long time to read.

Andrew   March 25th, 2009 13:28 ET

Was always told I was allergic to pennicillin since day 1. I have a heart murmur that I needed to take special antibotics for every dentist appointment. I recently went and got tested (22 years after being told I will always be allergic) and no allergy whatsoever. This included 2 skin tests, 2 injections and a 10 day oral challenge. The allergist is prepared for an emergency and it is in a controlled environment. Total visits cost : $120 + $70 for the meds. Worth it so I can now use penicillin instead of overly expensive other antibiotics.

JD   March 25th, 2009 16:55 ET

I desperately need to be tested since I have a strong family history of severe penicillin allergy (close family member goes into anaphylactic shock if exposed). My pediatrician would not prescribe it to me for this reason. It would be nice to know if I could use it, if needed. Much cheaper than any of the alternatives.

Nicole   March 27th, 2009 12:42 ET

When I was 5 or 6 I had terrible recurring bouts of ear infections. They always put my on the pink liquid Amoxi-drops (Amoxicillin). After a few years I never had the problem (or amoxicillin) again. Then in college I ended up with some chest infection and since I was definitely allergic to sulfu they put me on Amoxicillin. After about the 6th day I broke out in the biggest hives I have ever seen. They were inside my mouth, in my ears, everywhere. Drs told me that I had developed an intollerance from the heavy doses during my childhood. I have not actually had plain old penecillin, but I was advised to stay a way from any of the -cillin drugs.

Dolly Rickerman   April 1st, 2009 22:10 ET

My 10 year old son, who has had amoxicillin before, broke out in hives on his 9th day of treatment (the 10th day was his last day to get the medicine). He was being treated for a sinus infection. His pediatrician said that he had an allergic reaction to the amoxicllin and that he should never be given any penicillin. He wants my son to be tested again in a year with a full allergy test...why does he have to wait a whole year?

Julianne   April 3rd, 2009 14:37 ET

I am currently fourteen-years-old.

Two years ago had severe allergy to something. My doctor percribed me amoxicillin. A few minutes after taking the first dose, I broke out in hives. My dad (a paramedic, and has a nurses degree), said that maybe I was allergic to the medicine. So, I took it a second time. Again, I got hives. He said I was allergic and my parents have written it in for things I am allergic to on forms and such.

Theresa   April 3rd, 2009 17:26 ET

Several years ago I went to the doctor and was prescribed pencillian, I started to get better during the 10 day regimen. However about day 7 I started having extreme joint pain I could barely move, day 8 I broke out in a rash all over on day 9 I called the pharmacists to see if these new symptoms were an allergic reaction, he said yes to stop taking the medicine (I had one day left). Since that epsiode I have always told my doctor that I am allergic to penicillian but recently when visiting the doctor for an ear infection I was asked how long it had been since I tried pencillian, I wondered why the on-call doc asked me, I see the answer from this arrticle. I could not remember but I think it has been more than 10 years ago. I will have the office visit test done soon to double check!

Sharon   April 9th, 2009 05:28 ET

I have been considered allergic to penniclin since I was between 6-8. I had massive ear infections in which I would be going to the ER every week (stupid military doctors wouldn't let get tubes in my ears, as I am still plauged with them today) I remember always getting sick immeaditly after taking the meds (and it was liquid pennicilin and amoxicilin as well) today I am now allegric to all antibotics to a point to where I have bad spasms and my throat will start to swell, so no I have no plans to get retested...to scary to think about (I will just stick with the on sulfa drug that does work...yes the side effects are bad, but not near as bad as being violently ill and feeling like I cant breathe)

negmyblog   April 14th, 2009 06:00 ET

At around age 3 my son was given pennicilin for some infection. Within a few hours he developed hives...We took him to the ER and we were asked what he had taken...with that, they decided he was allergic to pennicilin.

About a year later we moved out of the US. My son got sick and the pediatrician (an old man...) prescribed him pennicilin...When we realized what he had done, we called him immediately and argued with him that we were told and had already told him that my son was allergic...His response? "I'm the doctor, so just give him the medicine I gave you...he'll be fine..." Slightly frightened we gave him his "pennicilin" terrified that something would go wrong...NOTHING DID...Our old pediatrician doctor obviously knew much more than the other doctors we had previously seen.

To this day when asked I always tell the doctors he is allergic to pennicilin ONLY because in the US there are so many restrictions on parents from Child Protective Services...that we worry that if we don't tell the doctors and something does go wrong, some CPS agent will call us negligent and take our child away...Do we believe he is allergic at this point? Not really...Our old doctor out of the country obviously knew well...

I would love to have my child tested.

Tim   April 16th, 2009 11:42 ET

I have also been told that I am allergic to penicillin since I was a pre-teen. I am now almost 41 and would love to be tested. I had to see an on call Dr recently who asked me how I knew I was allergic to penicillin. He then proceeded to tell me that same thing that a lot of people have been told that they are allergic and are really not.

Kathy   April 21st, 2009 10:05 ET

I have had allergies to food andf medicine since I was in my 30's. Once when I was in the hospital the doctor gave me penicillin knowing I was allergic to it. I had a wrist band with the info as well as on my chart, I was give the penicillin and after that I blew up with hives and my lips were swollen. Thank GOD I was in the hospital at that time so they gave me medicine to counter react the penicillin immediately . It was not a good expericence..After about 15 years, I tried Ceftin, which has penicillin in it, and I had no reaction. So I do wonder if this is true that after ten years it is ok. I am also HIGHLY allergic to SHELLFISH, which I am not ready to try and find out if I am still allergic. This allery to Shellfish almost kiled me. I have been recently tested for allergies and it's a never ending saga of when do these allergies pass, so I don't have to be so afraid of what can happen if I do eat or receive medicine that I am allergic to.

Elizabeth   April 27th, 2009 21:30 ET

I have a 3 year old son. On his first birthday, he aquired some terrible flu, with a temp of 105 that I could not get to stay down. His pediatrican prescribed penicillin, and just after his first dose, broke out in red dots (hives?) which began on the bottom of his feet and began to spread up his legs. Doctor said he was allergic to penicillin, but I would be interested in testing him to know for sure, as long as there were no negative effects from the testing.

Yellow   May 25th, 2009 20:12 ET

I've been told I was allergic to penicillin from birth, but at this time they were not sure I was allergic to penicillin or if it was the other medication I was taking. I was always ill as a child and penicillin was the one thing that was never an option for me just because of my mothers fear of me being allergic to it. At the age of 2 or 3; not to sure on the age, I became very ill, and my normally doctor was not able to see me. The other physician I was told to see gave me a very low dosage of penicillin even though on my medical chart it states I was allergic to it. Instead of getting better I became more ill and broke out in a large rash. The rash covered me from head to toe and my mother didn’t know what to do. She took me to emergency and explain to them what I had been given and what had happen. I remember her telling me that the doctors in emergency told her if she knew I was allergic why did she let the doctor give it to me and even to this day she does not know, but after this incident she made sure to make a note of telling the doctors over and over about my reaction to it. To this day I still have to state that I am allergic to penicillin, but because a lot of things I was allergic to as a child my reactions are not as bad as an adult I think I would consider being tested only if my doctor thinks it’s best, other than that I’ve gotten this far in life with out having to have any form of a penicillin dosage so I think I should be fine if I never do.

Highly allergic   May 28th, 2009 18:35 ET

Yes, some people are deathly allergic to penicillin. I am 53 years old today. When about 10 years old, I took the medicine in pill form. Two days later the reaction started. It lasted for about 7 to 8 weeks. Basically I had severe swelling in the form of a welt that covered my entire body for that duration. The itch could never be satisfied as its in your blood. I sat around for days & weeks with ice packs all over my body, couldn't sleep, taking drugs like benadryl every 4 hours, about 10 pills at a clip. After a couple weeks I gradually lowered the benadryl dosage by 1 pill a week. As an adult, my sister had a drug, amoxcillin, and reacted worse than me. She too was highly allergic though she had taken the drug as a child. She swelled so badly, that she actually became paralyzed–the blood gets into the bones and eventually the joints. The joints swelled so badly she became paralyzed and hospitalized for weeks. This is not a drug to mess around with if you might have an allergy to it.....

Laurie   June 6th, 2009 11:26 ET

I was tested at Kaiser Permanente several years ago and am happy to report that I am Not allergic to penicillin. I still have not taken it to really know if it is OK to take. If you have ever been told that you are allergic to Penicillin, you should get tested as it opens up a whole group of medications available. I hope that the scientists find ways to test other drugs as I'm allergic to several antibiotics.

Laurie

Margie   June 16th, 2009 21:45 ET

In my 30s, mainly, I got a lot of colds, sinusitis, etc. I often got a few red bumps, mainly on my inner arm, after taking antibiotics. I thought they were hives. When I reported this to the prescribing doctors (or pharmacists, if the doctor's office was closed), they told me to stop taking it and try something else. I had this reaction to Ceclor (cephalosporins), sulpha, and penicillin (or penicillin-related drugs). I also ended up in the hospital with severe diarrhea and horrible stomach cramps from Augmentin (which some say was a side effect and some say was an allergic reaction).

At any rate, one doctor asked me to see a dermatologist and get tested. The only test they had for these antibiotics was for penicillin. I had the skin test in his office and, to my surprise, tested positive - and I only had a few hives!!! I was surprised because I thought I probably had been overcautious when I reported a few red bumps to the doctor. At that time, I took warnings to patients about side effects pretty literally (the patient info. included with the medicine), although, like in these cases, I felt I was being overly cautious. BOTTOM LINE: What the pharmacists and doctors generally told me seemed more believable AFTER I TESTED POSITIVE FOR A PENICILLIN ALLERGY. What they always said was that AN ALLERGY THAT MANIFESTS IN A FEW HIVES ONE TIME MIGHT MANIFEST IN AN ANAPHALACTIC (sp.?) REACTION (POTENTIALLY LIFE-THREATENING OR FATAL) ANOTHER TIME.

I'D REALLY LOVE SOME PHYSICIAN RESPONSE TO THIS - AND ALSO RE: 1) THE FALSE POSITIVE RATE FOR THE 15-MINUTE(or thereabouts) SKIN TEST FOR PENICILLIN ALLERIES, AND 2) WHETHER THERE ARE TESTS FOR THE OTHER ANTIBIOTICS. Thank you very much!!! Margie

Jerry   July 31st, 2009 16:31 ET

So what if I'm allergic to PCN? There are enough other options that it doesn't matter one bit.

Robert Austin, TX   August 13th, 2009 05:22 ET

Similar to the author, I was given Polycillin at a University Health Center
in the early 1970's, and when I developed a dotted rash on my forearms
a few days later, the physician told me the rash confirmed I was allergic, discontinued the medication and told me to never take Polycillin nor
Penicillin again. I followed his advice, and would love to be tested these some 35 years later to find out if I am actually (still) allergic to this useful and practical family of drugs.

sarah jones   August 18th, 2009 18:43 ET

i am allergic to penicillin.. waht other type of medication can i take?

Jean   August 25th, 2009 14:46 ET

Yes, I would consider being tested. I developed an allergic reaction to Penicillin in 2006 and have since added Amoxicillin, Clindamycin and Bactrim to the list, having reacted to each of those. I am concerned that I am running out of antibiotics to take in the event of a serious health issue.

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Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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