Are you sure you’re allergic to penicillin?

Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning.

Let’s talk penicillin.

Sommer aid, “It’s usually children when they start off with their bacterial infections, they will get prescribed penicillin or amoxicillin. It’s a common antibiotic prescribed for upper respiratory infections, ear infections, sore throat, pneumonia, all them. Amoxicillin really covers a lot. The biggest problem becomes if you are penicillin allergic.”

Sometimes people think they have a penicillin allergy, but they may not.

Sommer said, “That is according to the CDC. The reason why I bring this up is we cross this path a lot with our patients, when they go for surgery. Normally they’ll give a gram of Ancef, which even though it’s a cephalosporin, in the past that says, if you had a severe allergy to penicillin, you shouldn’t have Ancef, which poses an issue for the surgeon to scrambled to find a different antibiotic. However, doing a little bit more homework with a lot of patients, they will say, oh, my mother told me I’m allergic to penicillin. Well, did you ever have a reaction? No, not that I can remember. But it’s a family history and family history doesn’t really play into part with actually having a penicillin allergy. It’s a case by case basis.”

Penicillin can have side effects, but that’s not really an allergic reaction.

Sommer said, “A lot of times, and that’s with any antibiotic, you can have an upset stomach, you could feel nauseous, you can have our good old friend diarrhea. When people will say, oh, I’m allergic to penicillin, you can make a note in the chart. However, as certain antibiotics are becoming resistant to certain bacterias, doctors now I guess, are actually trying to de-label the allergy to penicillin, for some people, because they find themselves caught in a rock and a hard place, certain patients present with something that would really benefit from a penicillin based antibiotic, and they can’t. So they’re trying to test to see if there really is an allergy.”

How is that done?

Sommer said, “Vanderbilt University is doing it by, it was very interesting. If you had mild symptoms, I’m guessing going along with the nausea, vomiting and diarrhea, they will actually in a controlled environment give you a tablet of amoxicillin and wait 90 minutes to see if there is a reaction. Then if you had, I don’t know how I feel about this, but if you had a severe allergic reaction, they would do a three hour study where they like prick your finger with a little bit of penicillin, and wait and stare at you. If nothing happens, they go intradermal, which is just under the skin, which is typical for allergy testing. Then they would give you the pill to see if anything happened. Obviously, they know what they’re doing. It’s just to debunk the myth of penicillin, because a lot of people say, oh, my mother told me or I have a family history of, and they’re paranoid or afraid to take penicillin, which you may somewhere in your lifetime, that might be the right choice of antibiotic for you.”

Amoxicillin is in the penicillin family.

Sommer said, “I believe it’s the second generation. They have generations of antibiotics. There are people that will say they are allergic to penicillin and have a reaction to amoxicillin.”

It looks like only about 1% of the population is actually allergic to penicillin.

Sommer said, “Because people have had the allergy, doctors again, had to scramble for certain antibiotics that will cover it, but maybe not as well as penicillin. So then people tend to have to be on a longer course of antibiotics because they can’t take penicillin. So really, I mean, if you’re allergic, you’re allergic. I personally I think I am allergic. I blew up like a balloon. So I didn’t have a rash. I didn’t have nausea, vomiting. My face was swollen. So that was penicillin, so I truly probably am allergic to penicillin. However, I also had a rash with Keflex and erythromycin as a child that my pediatrician labeled me as being allergic. So I have three antibiotics I’m allergic to, which makes it really difficult to treat me. A lot of times I think they give me Levaquin or tetracycline, doxycycline. There had been studies concerned in the past that if you’re allergic to penicillin not to get the Ancef.”

How can people truly find out if they are allergic?

Sommer said, “If you’ve really never had a reaction that you can recall or that your mom or a parent can recall and you have kind of like chronic conditions, I found this article and it started with this girl that had chronic sinus infections, and they were finding it really hard to treat her and so that’s why they did this and she’s not allergic to penicillin, so she was able to go on it. It might be something to look into if you have some type of recurring infection that would benefit from penicillin, but you’re not really sure. You can talk to your doctor about it. This is new to me. When I found this article, I thought this was interesting. So obviously, talk to your doctor. A lot of allergists are the ones that are testing it. So it’s just something you might want to keep in the back of your mind.”

Don’t forget about the PicoSure pro laser at Key West Surgical Group.

Sommer said, “We’ve had a couple of people come in, they just want to be rid of those old bad memories, or just the bad art. I mean, some of them, it’s a shame, you can’t even tell what they are anymore.”

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