David M. Lang, MD, FAAAAI
President, American Academy of Allergy, Asthma & Immunology
Roughly 10 percent of the population self-reports having an allergy to penicillin or a penicillin-type drug, and the unintended consequences of these reports can be severe.
Recent evidence suggests most patients with an unverified penicillin allergy needlessly avoid penicillins. Over 90 percent of patients who self-report would test negative for a penicillin allergy, meaning their bodies will tolerate penicillins without having an allergic reaction.
The cost of alternative care
The bigger problem is that penicillin allergy is an often overlooked factor that contributes to antibiotic resistance. If someone is labeled with a “penicillin allergy,” health care providers will treat their infections with alternative antibiotics when a penicillin would be the drug of choice.
Receiving an alternative, non-penicillin antibiotic can result in higher costs of care, greater risk for adverse effects, and longer hospital stays. Alternative antibiotics will also encourage antibiotic-resistant bacteria to emerge.
How much of a threat is antibiotic resistance? According to the Centers for Disease Control and Prevention, antibiotic-resistant bacteria cause at least 2 million illnesses and 23,000 deaths each year in the United States alone.
Even young children, pregnant women, and critically ill patients can safely receive penicillin allergy skin tests, which can determine whether avoiding penicillin is necessary. Penicillin allergies are often diagnosed during childhood, when common infections may contribute to or be confused with an allergy. Even if you had a true allergy, over 90 percent of people grow out of this tendency by avoiding penicillin for 10 years or more.
If you think you’re allergic to penicillin, talk to your doctor about getting tested. Undergoing appropriate diagnostic evaluation with a board-certified allergist will often lead to removing the diagnosis of a penicillin allergy.