Penicillin allergy has been recognized since the 1940s and penicillin skin testing has been utilized since the 1960s. However, in recent years evaluation of penicillin allergy has taken on increased importance, since the inappropriate labeling of patients as allergic leads to more deleterious clinical outcomes compared to those who do not carry the label. Additionally, the approach to evaluating penicillin allergy has evolved with 1) proceeding directly to challenge without skin testing, 2) skin testing with only Pre-Pen or only penicillin G and not minor determinant mixture (MDM) or amoxicillin/ampicillin, and 3) challenging with a single dose vs a five or ten day course. Lastly, various approaches have been developed to evaluate penicillin allergy in hospitalized patients.
Upon completion of this activity, participants should be able to:
- Recognize why penicillin allergy is a public health problem
- Describe the different approaches to penicillin skin testing and challenges
- Identify different approaches to managing penicillin and beta-lactam allergy in hospitalized patients