Penicillin skin testing in the evaluation and management of penicillin allergy

Stephanie Fox, Miguel Park

Research output: Contribution to journalReview article

45 Citations (Scopus)

Abstract

Objective: To review the role of penicillin skin testing in the evaluation and management of penicillin allergy mediated by IgE. Data Sources: PubMed and OVID search of English-language articles regarding penicillin allergy, penicillin allergy testing, and management of penicillin allergy. Study Selection: Articles pertinent to the subject matter were selected and reviewed. Results: The major determinant (benzylpenicillin polylysine) detects the greatest number of penicillin allergic patients during skin testing, and the minor determinants of penicillin increase the sensitivity of penicillin skin testing. Penicillin skin testing to the major and minor determinants was found to have a negative predictive value of 97% to 99%. The incidence of systemic adverse reaction to penicillin skin testing is less than 1%. Conclusion: A detailed history of the prior reaction to penicillin is an integral part of the evaluation, but it is not accurate in predicting a positive penicillin skin test result. A patient with a negative penicillin skin test result to the major and minor determinants is at a low risk of an immediate-type hypersensitivity reaction to penicillin. Patients with a positive skin test result should undergo desensitization to penicillin or an alternative antibiotic should be considered.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalAnnals of Allergy, Asthma and Immunology
Volume106
Issue number1
DOIs
StatePublished - Jan 1 2011

Fingerprint

Penicillins
Hypersensitivity
Skin
Skin Tests
Immediate Hypersensitivity
Polylysine
Penicillin G
Information Storage and Retrieval
PubMed
Immunoglobulin E
Language

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Penicillin skin testing in the evaluation and management of penicillin allergy. / Fox, Stephanie; Park, Miguel.

In: Annals of Allergy, Asthma and Immunology, Vol. 106, No. 1, 01.01.2011, p. 1-7.

Research output: Contribution to journalReview article

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