Many people who think they are allergic to penicillin are not

The Royal Pharmaceutical Society has issued a warning that approximately 6% of individuals in the UK are erroneously labeled as allergic to penicillin in their medical records.

This statistic raises concerns as those mislabeled with an allergy to this potent antibiotic face a mortality rate of 6 in every 1,000 patients annually after infection treatment. Correct administration of infection antibiotics could save many lives.

Allergies vary, but those allergic to penicillin often exhibit symptoms such as rash, itching, swelling, tightness in the throat, and difficulty breathing.

Diagnosing penicillin allergy in individuals with general discomfort can be challenging. Typically, it arises when treating febrile children with signs of ear or throat infections using penicillin. If they develop a rash, doctors may note antibiotic allergy in their medical history for safety.

This is because individuals allergic to penicillin often respond poorly to subsequent doses, which may include potentially fatal reactions known as allergic reactions.

Preventive and often false “penicillin allergy” labels are likely to accompany individuals through childhood into various medical records without scrutiny. These individuals continue to avoid penicillin treatment, primarily relying on the presence of a rash.

However, a fever accompanied by a rash can have various causes. Many enteric viruses, as an example, can cause rashes during illness. If patients are treated with amoxicillin (an antibiotic in the penicillin family), the Epstein-Barr virus often causes a rash. Not all rashes caused by penicillin are allergic; they are merely side effects of the medication.

Identifying allergic reactions

Other symptoms that may arise during penicillin treatment, such as diarrhea or vomiting, may indicate adverse reactions to antibiotics but not necessarily allergies, posing no future risk of allergic reactions. Some studies suggest that patients who have had actual allergic reactions to penicillin may lose this sensitivity over time, and it remains unclear whether penicillin allergy is lifelong.

Individuals labeled with “penicillin allergy” in their medical history experience worsened health conditions and increased antibiotic resistance when treated with alternative broad-spectrum antibiotics. Broad-spectrum antibiotics can kill a variety of bacteria, not just those suspected to cause the infection.

Further research indicates an elevated risk of postoperative infections, readmissions, and infections with the MRSA superbug in “penicillin allergy” patients. These consequences pose a significant cost to patients, their families, and healthcare services.

Confirming your allergy status

Penicillin allergy can be confirmed by collecting precise information about its development, sometimes through skin prick tests or, when necessary, oral administration of minimal penicillin doses. It is the responsibility of general practitioners, nurses, and pharmacists to scrutinize drug allergy labels in medical records. Large-scale surveys indicate that these methods make it nearly safe for everyone to take this range of antibiotics.

Penicillin is commonly used as part of the treatment for sickle cell anemia patients, who take antibiotics twice daily for a lifetime. Sickle cell anemia is a common genetic disease, and in the UK, over 12,000 people undergo regular follow-ups, with penicillin allergy cases being rare. This should provide assurance regarding the safety of penicillin, placing allergies in a more reasonable perspective.

Accurate, up-to-date information is needed to support your health and the well-being of others. If you suspect a penicillin allergy, it is wise to discuss and confirm it with your doctor. Removing this label can be beneficial for you and others.

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