The Bernstein Allergy Group specializes in evaluation of drug allergy and is one of the few practices in the tri state to offer complete penicillin skin testing to patients who require testing.
Allergy reactions can occur with just about any drug. Penicillin antibiotics and penicillin like drugs represent the most common causes of drug allergies. Allergic Drug Reactions to penicillin can range from mild rashes or hives to life threatening allergic reactions, otherwise referred to as anaphylaxis. Penicillin and penicillin like drugs are the most common causes of life threatening anaphylaxis. For this reason, persons who have had a history of any allergic reaction to penicillin are instructed by their physicians not to take penicillin again for fear they could experience a life threatening allergic drug reaction. We have learned, however, that most people who have experienced allergic reaction to penicillin in the past will lose their allergy over 10-20 years. If patients with a history of allergy to penicillin require penicillin treatment for an infection, penicillin skin testing can be performed to determine if allergy is still present or not. A negative skin test to penicillin would indicate that a patient can receive penicillin, despite a previous allergic reaction in the past. A positive skin tests indicates active allergy and that penicillin should continue to be avoided.
Other Drug Allergies:
Just about any drug can cause an allergic reaction. In addition to penicillin, some of the drugs which commonly cause allergy are sulfa antibiotic drugs (Bactrim, for example), the seizure drugs (dilantin, for example), as well as anticancer treatments. Unlike penicillin, there are no specific tests for most of these drugs. In general, doctors will advise patients to avoid a drug to which they have experienced an allergic reaction. This is very good advice for most drugs that have caused serious reactions in the past. There are certain situations when a drug can be given safely in a patient who has experienced a previous drug reaction:
- Local anesthetics (xylocaine or lidocaine, for example): Many patients experience unusual symptoms after receiving an injection of the local anesthetic for minor surgery. Most such reactions are not truly allergic, although some are. An allergist can determine if a patient is able to receive a local anesthetic by performing a "Graded Drug Challenge" in the clinic and under supervision. In most cases, a suitable anesthetic agent that is tolerated can be found.
- Aspirin desensitization: this is occasionally recommended for patients with aspirin allergy, severe sinusitis, nasal polyps and asthma who fail to respond to medication treatment. Despite the fact that asthma or swelling has been triggered by taking a normal dose of aspirin or ibuprofen in the past, a procedure known as aspirin desensitization performed over several hours in the allergy clinic can allow patients to tolerate much higher doses. In fact, aspirin desensitization may sometimes be therapeutic and actually benefit asthma and sinusitis conditions in aspirin sensitive patients.