Abstract
The purpose of this study was to compare the management of patients with a history of penicillin allergy between allergists and non-allergists in Thailand. A questionnaire was distributed to Thai physicians by online survey. The answers from 205 physicians were analyzed. The discrepancy of penicillin allergy management between allergists and non-allergists was clearly demonstrated in patients with a history of an immediate reaction in the presence of penicillin skin test (P < 0.01) and in patients with a history of Stevens-Johnson syndrome (P < 0.05) from penicillin. Allergists are more willing to confirm penicillin allergic status, more likely to carefully administer penicillin even after negative skin test, but less concerned for the potential cross-reactivity with 3rd and 4th generation cephalosporins, compared to non-allergists. The lack of penicillin skin test reagents, the reliability of penicillin allergy history, and medicolegal problem were the main reasons for prescribing alternate antibiotics without confirmation of penicillin allergic status. In summary, the different management of penicillin allergy between allergists and non-allergists was significantly demonstrated in patients with a history of severe non-immediate reaction and in patients with a history of an immediate reaction when a penicillin skin test is available.
Highlights
Penicillin allergy is one of the most commonly reported drug allergies worldwide
Since the prescription of alternate antibiotics may have undesirable consequences in terms of antibiotic susceptibility, adverse reactions, and health economics, the confirmation of penicillin allergic status would be beneficial in patients with a suspected history of penicillin allergy
The Management of Patients with a History of PenicillinInduced Immediate Reaction according to the Availability and Result of Penicillin Skin Testing
Summary
About 10% of the general population report suspected allergic reactions to penicillin [1]. Most physicians prefer to prescribe alternate antibiotics to these patients, unless a penicillin allergic status can be excluded [3, 4]. Since the prescription of alternate antibiotics may have undesirable consequences in terms of antibiotic susceptibility, adverse reactions, and health economics, the confirmation of penicillin allergic status would be beneficial in patients with a suspected history of penicillin allergy. The confirmation of penicillin allergic status is not always feasible, which results in unnecessary avoidance of beta-lactam antibiotics in patients who are overdiagnosed [5]. Allergists, physicians specialized in managing allergy and immunology disorders, are responsible for confirming penicillin allergic status, preventing overdiagnosis, and determining appropriate alternative antibiotics. The selection of antibiotics in these patients is often decided by doctors of other specialties in real
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
