title: Penicillin allergy: a practical approach to management.
abstract: Although penicillin is nontoxic, it is highly immunogenic and is the most common drug that causes allergic reactions. A previous reaction to penicillin has been shown to be unreliable in predicting sensitivity in 75% to 90% of patients. To more accurately test for penicillin allergy, diagnostic skin test reagents have been developed; these include the major determinant (benzylpenicilloyl-polylysine) and the minor determinant mixture (penicillin G potassium, benzylpenicilloate sodium and benzylpenicilloyl-N-propylamine). Penicillin skin testing has been shown to be safe and useful in predicting immediate IgE-mediated reactions (overall predictive value 99%). Reactions that occur when patients are challenged with penicillin are mild or accelerated urticarial reactions. We outline a practical and rational therapeutic approach based on the current understanding of penicillin allergy.
mesh_terms: D003888:Desensitization, Immunologic / Q000379:methods; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005188:False Negative Reactions; D006801:Humans; D007202:Indicators and Reagents; D010400:Penicillin G / Q000276:immunology; D010406:Penicillins / Q000009:adverse effects*; D012882:Skin Tests / Q000379:methods
chemical_list: D007202:Indicators and Reagents; D010406:Penicillins; D010400:Penicillin G