IV Penicillin Safety in Those With Allergy History But Negative Skin Test

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A total of 111 courses of penicillins were administered intravenously to the 32 patients included in the study
A total of 111 courses of penicillins were administered intravenously to the 32 patients included in the study

According to results of a retrospective review performed between 2010 – 2016, intravenous administration of 2 or more courses of penicillin antibiotics is safe in patients with a reported penicillin allergy and a negative penicillin allergy test.

A total of 32 adult patients with a reported penicillin allergy, a negative penicillin skin test and oral challenge, who received at least 2 courses of intravenous penicillins, were included in the study. Patient charts were utilized to identify adverse drug reactions.

A total of 111 courses of penicillins were administered intravenously to the 32 patients included in the study. The authors reported that no patients developed an immediate hypersensitivity reaction during these courses of administration.

The study authors noted that, in these patients, 75% of reported penicillin-associated reactions had occurred greater than 10 years ago with the severity ranging from rash to hypotension. Analysis also found that greater than 50% of these patients had also received at least 3 courses of intravenous penicillins. 

Repeated intravenous administration of penicillin antibiotics appears to be safe in patients with a reported penicillin allergy and a negative penicillin allergy test. The study authors noted, however, that “larger prospective studies should be performed to confirm these observations.”

Reference

Dorman SM, Seth S, Khan DA. Risk of allergic reactions to recurrent intravenous penicillin administration in penicillin skin test negative patients [published online August 9, 2017]. J Allergy Clin Immunol Pract. doi: 10.1016/j.jaip.2017.06.014

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