Penicillin skin testing is a safe and effective tool for evaluating penicillin allergy in the pediatric population

Stephanie J. Fox, Miguel A. Park

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Background: Penicillin skin testing has been validated in the evaluation of adult patients with penicillin allergy. However, the commercially available benzylpenicilloyl polylysine (Pre-Pen) is not indicated in the pediatric population. Moreover, the safety and validity of penicillin skin testing in the pediatric population has not been well studied. Objective: We describe the safety and validity of penicillin skin testing in the evaluation of children with a history of penicillin allergy. Methods: Children (<18 years) with a history of penicillin allergy were evaluated with penicillin skin tests and were reviewed for basic demographics, penicillin skin test results, adverse drug reaction to penicillin after penicillin skin test, and adverse reaction to penicillin skin test. By using the χ2 test, we compared the differences in the proportion of children and adults with a positive penicillin skin test. P value (<.05) was considered statistically significant. The institutional review board approved the study, and all the subjects signed written informed consents. Results: A total of 778 children underwent penicillin skin testing; 703 of 778 patients had a negative penicillin skin test (90.4%), 66 had a positive test (8.5%), and 9 had an equivocal test (1.1%). Children were more likely to have a positive penicillin skin test (P < .0001) compared with adults (64 of 1759 [3.6%]); 369 of 703 patients with negative penicillin skin test (52%) were challenged with penicillin, and 14 of 369 patients (3.8%) had an adverse drug reaction. No adverse reactions to penicillin skin testing were observed. Conclusion: Penicillin skin testing was safe and effective in the evaluation of children with a history of penicillin allergy.

Original languageEnglish (US)
Pages (from-to)439-444
Number of pages6
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume2
Issue number4
DOIs
StatePublished - Jul 2014

Keywords

  • Adverse drug reaction
  • Pediatric
  • Penicillin allergy
  • Penicillin skin testing
  • Safe

ASJC Scopus subject areas

  • Immunology and Allergy

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