How can I tell if I’m allergic or not allergic to penicillin?

QUESTION: As far back as I can remember, I’ve been told that I’m allergic to penicillin and that I should never take it. Now my family physician wants to test me, in the office, to be sure. Is that safe?

ANSWER: Penicillin allergy is frequently misdiagnosed, with somewhere between 90 to 95% of people who are told they have a penicillin allergy actually not being allergic at all.

This happens for a couple of reasons, antibiotics can have side effects, like rashes, that can be confused with an allergy.

For example, older penicillin shots had an oil to which people had a reaction.

More importantly, about 80% of people who are allergic to penicillin lose their sensitivity after 10 years.

This is a serious health concern because patients who are labeled as penicillin-allergic may be given alternative antibiotics that are less effective and can lead to longer illnesses.

What’s the Best Practice to find out?

So, the best practice now is, “To determine if a patient is truly allergic to penicillin, doctors should get an accurate medical history and consider allergy testing.”

The question for us doctors has been, “What’s the safest way to do this?”

For years, most of us have been referring our patients to allergists for this testing. But now there’s another option.

A 2021 study concluded, “People labeled as penicillin allergic can be safely challenged in primary care.”

The American Family Physician journal advised family physicians, “This study reports the outcome of an amoxicillin oral provocation challenge in 99 adults and children who were initially labeled as having a penicillin allergy and were subsequently identified by their history to be at low risk of a true allergy.

“A total of 96 patients (97%) completed the oral provocation challenge with no reaction, resulting in the removal of the erroneous allergy label. The three reactions were all mild and required minimal intervention (i.e., no epinephrine).”

AFP concluded, “Having primary care physicians use this method to identify the millions of adults and children who are incorrectly labeled as having a penicillin allergy may result in significant health care savings from the use of less effective, more expensive, or less safe alternative antibiotics.”

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Walt Larimore, MD, has been called one of America’s best known family physicians and has been named in the “Guide to America’s Top Family Doctors,” “The Best Doctors in America,” “Who’s Who in Medicine and Healthcare,” and “Who’s Who in America.” He’s a former Vice President and Physician in Residence at Focus on the Family and the American Life League has named him a “Rock-Solid Pro-Life” awardee. He’s also an award-winning medical journalist and the best-selling author of over 40 books. He and his childhood sweetheart and wife of nearly 50 years, Barb, have two adult children and reside in Colorado Springs. You can find Doctor Walt’s health blog at www.DrWalt.com and follow him on Facebook at “DrWalt.com”. Have questions for Dr. Walt? Email them to editor@todayschristianliving.org.