Are You Really Allergic to Penicillin?

Penicillin Allergy Misdiagnosis Common, New Testing Protocols Offer Hope

auburn, Alabama – August 3, 2025 – Millions might potentially be unnecessarily avoiding penicillin, a highly effective antibiotic, due to incorrectly labeled allergies. Recent advancements in allergy testing, detailed by Auburn University pharmacy professor Elizabeth W. Covington, are offering a pathway for individuals to safely determine if they can once again utilize this crucial medication. The Centers for Disease Control and Prevention (CDC) estimates that up to 10% of adults report a penicillin allergy,but studies suggest the true rate of allergy is significantly lower – around 1%.

Determining a true penicillin allergy begins with a thorough discussion with a healthcare professional,such as a physician or pharmacist. Symptoms can vary widely, ranging from mild rashes to severe reactions like facial swelling and difficulty breathing. The healthcare provider will inquire about the initial reaction, the timing relative to antibiotic administration, any treatment received, and subsequent experiences with similar medications.These details help differentiate between a genuine allergic response and a non-allergic side effect.

Traditionally, penicillin skin testing has been the standard method for evaluating potential allergies. This involves a series of small skin pricks and injections using penicillin-related components to safely assess for a reaction.If the skin test is negative, a supervised oral challenge with a small dose of amoxicillin is often performed, with the patient closely monitored for any adverse effects.This process is typically conducted in a clinical setting,like the Allergy and Immunology clinic at the East Alabama Medical Center in opelika,Alabama.

However, a 2023 study published in JAMA Internal Medicine suggests a streamlined approach may be equally safe. This method involves directly administering a low dose of amoxicillin and observing the patient for approximately 30 minutes. Researchers at Massachusetts General Hospital in Boston, led by Dr. Kimberly Blumenthal, found this “direct oral challenge” to be a viable alternative, potentially reducing the need for initial skin testing in certain cases. The study involved 112 patients and reported a 0.8% rate of allergic reaction.

The increasing prevalence of antibiotic resistance underscores the importance of accurately identifying and resolving misdiagnosed penicillin allergies. Penicillin and related antibiotics remain highly effective against many common bacterial infections, and their availability is crucial for effective treatment. The American Academy of Allergy, Asthma & Immunology (AAAAI) provides resources for patients and healthcare providers regarding allergy testing and management.

(Elizabeth W. Covington, associate clinical professor of Pharmacy, Auburn University)

(This article is republished from The Conversation under a Creative Commons license. Read the original article here: https://theconversation.com/are-you-really-allergic-to-penicillin-a-pharmacist-explains-why-theres-a-good-chance-youre-not-and-how-you-can-find-out-for-sure-253839)