The rate of positive penicillin skin tests in patients with a history of penicillin allergy has declined in the last 20 years. Some investigators have proposed performing direct amoxicillin challenge (without preceding skin testing), whereas others continue to recommend a more cautious approach with negative penicillin skin testing before challenging. Most of the evidence for bypassing skin testing is in children, especially with benign cutaneous reactions. In adults, there are fewer data and hence less agreement among experts regarding whether direct challenge is appropriate.
LEARNING OBJECTIVES:
Upon completion of this activity, participants should be able to:
- Explain why direct amoxicillin challenge in patients with a history of penicillin allergy (without prior penicillin skin testing) may be safe and appropriate
- Outline the reasons why amoxicillin challenge may be performed more safely in patients with preceding negative penicillin skin testing
Moderator Introduction
Melissa Iammatteo, MD
Boston Children
Amoxicillin Challenge Without Preceding Penicillin Skin Testing in Patients with a History of Penicillin Allergy is Safe and Appropriate
David E. Vyles, DO
Children's Corporate Center
Amoxicillin Challenge Without Preceding Penicillin Skin Testing in Patients with a History of Penicillin Allergy is Not Safe and Appropriate
Miguel A. Park, MD
Mayo Clinic
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