title: The acceptability of a four-part protocol for penicillin allergy testing by practicing allergists.
abstract: Currently, there is no standard protocol to test for penicillin (PCN) allergy since PrePen (manufactured benzylpenicilloyl polylysine; AllerQuest, West Hartford, CT) was discontinued in 2004. Our article reviews allergist's opinions on a protocol to test for PCN allergy in patients without a history of a life-threatening reaction. This study was performed to determine whether fellows of the American Academy of Allergy, Asthma, and Immunology (AAAAI) would use a two-challenge PCN allergy protocol to test for PCN allergy while skin testing to the major determinant, benzylpenicilloyl polylysine, is unavailable. A questionnaire regarding PCN allergy and application of a four-step protocol was sent to 1210 allergists and immunologists. Of the 654 respondents, 324 (49.5%) believed that the protocol was practical in a busy, outpatient allergy practice and 64 (9.8%) wanted more information. One hundred ninety-four (29.7%) did not think it was practical. Two hundred ninety-five respondents (45.1%) then went on to respond that they would apply the protocol in an outpatient practice and 117 (17.9%) were undecided and wanted more information. One hundred thirty-five respondents (20.6%) would not apply the protocol in their practice. Of those who were undecided or did not think it was practical, 58 (8.9%) were awaiting PrePen, 33 (5%) wanted to see a larger protocol, 24 (3.7%) wanted more detail on the challenge, and 14 (2.1%) felt more comfortable desensitizing the patient. Forty-five percent of the fellows of the AAAAI would apply the proposed protocol to test for PCN allergy. Sixty-two percent said they may apply the protocol if a larger study was performed.
authors.affiliation: Division of Allergy and Immunology, Alfred I. duPont Hospital for Children, Nemours Children's Clinic, Wilmington, Delaware, USA.
authors.forename: Alyson B
authors.initials: AB
authors.lastname: Simpson
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Murphy
authors.forename: Ejaz
authors.initials: E
authors.lastname: Yousef
mesh_terms: D044482:Benzeneacetamides; D002985:Clinical Protocols; D003710:Demography; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D010400:Penicillin G / Q000031:analogs & derivatives; D010406:Penicillins / Q000009:adverse effects*; D010820:Physicians; D017410:Practice Guidelines as Topic; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D044482:Benzeneacetamides; D010406:Penicillins; C509029:benzylpenicilloyl G polylysine; D010400:Penicillin G