Pediatric penicillin skin testing with minor determinants and amoxicillin with or without oral drug challenge

Abstract

Penicillin (PCN) allergy is the most common reported drug allergy in electronic health records.1 However, true penicillin allergy occurs in less than 5% of patients with reported penicillin allergy.2,3 Penicillin skin testing (PST) alone, and PST followed by a formal medically supervised oral PCN challenge are each used in the evaluation of PCN allergy. We conducted a retrospective study to compare adverse reactions with subsequent PCN or amoxicillin exposure in pediatric patients with negative PST result that included benzylpenicilloyl polylysine, PCN G, minor determinants (penicilloate), and amoxicillin without oral dose challenge to negative PST result followed by oral penicillin challenge.