2/ True penicillin allergies are fairly rare, but you’ll see penicillins listed as an allergen for a decent chunk of your patients. A fraction of those who claim allergy will not tolerate penicillins when challenged with one.
3/ And this isn’t a benign thing, slapping the penicillin allergy label on folks willy nilly; there are consequences - prescribing changes, and then the microbiology changes, too.
4/ Some simple questions can help to clarify the nature of the reaction to penicillins.
5/ Based on what you learn, you might consider challenging a patient and watching them. Or if they’re higher risk, you can consider skin testing followed by desensitization or a direct oral challenge.
6/ Finally, does a penicillin allergy mean you can’t give ceftriaxone or meropenem? No! There’s some cross reactivity, but it is rare; the graphic below arms you with the data of just how common the allergic cross reactivity is.
7/ Shout outs to the village that brought this baby into the world!
Hosts: @AnnKumfer, @ShreyaTrivediMD, @dhtaupin | Experts: @nedafrayha @KimberlyBlumen1 | Graphic: @docscribbles | Audio: Max Had | Peer Review: Qura Tul Ain Rashid, MD
Hosts: @AnnKumfer, @ShreyaTrivediMD, @dhtaupin | Experts: @nedafrayha @KimberlyBlumen1 | Graphic: @docscribbles | Audio: Max Had | Peer Review: Qura Tul Ain Rashid, MD
8/ To recap: true penicillin allergies are rare, but folks are frequently given this label with real consequences. Look into it, and consider a challenge or desensitization. And don’t forget your cephalosporin/monobactam/carbapenem friends!
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