Some 30 million Americans believe they are allergic to penicillin or a penicillin-related antibiotic. When tested, however, fewer than 1 percent have a telltale reaction to the drug, according to the Centers for Disease Control.
In other words, they think they are allergic to the original miracle drug when they are not.
Fortunately, area residents now have an easy way to find out if they truly have the allergy.
Health First’s Holmes Regional Medical Center in Melbourne is offering penicillin allergy tests.
Michael Sanchez, PharmD and Clinical Pharmacy Manager at Holmes, said the program began for patients in the hospital in 2018 and was so successful that in 2022 they started offering it on an outpatient basis. People wishing to have the test need only to ask their physician for a referral.
Learning if you truly have the allergy is important. The alternative to penicillin or penicillin-based drugs like amoxicillin is usually broad-spectrum antibiotics. These work but they often are not physicians’ first choice and can lead to antibiotic resistant bacteria – and they’re more expensive.
According to Pharmacy Times, unverified penicillin allergies cost both patients and their healthcare systems millions each year. Patients with penicillin allergies pay as much as 63 percent more for antibiotics than those without allergies.
Inaccurate diagnoses of penicillin allergies can also result in antibiotic resistance that leads to the spread of superbugs. Patients who are allergic to penicillin may need to take stronger and more toxic antibiotics to treat a mild infection. These antibiotics are typically reserved for the treatment of difficult-to-treat infections such as MRSA and C difficile, and inappropriate use can lead to more virulent bacteria, according to a study published by the British Medical Journal.
The study adds that bringing awareness to the high rate of misreported penicillin allergies is an important part of identifying true allergies and eliminating false ones, in order to lower costs, reduce adverse effects and prevent antibiotic resistance.
Sanchez said that the three-step test at Holmes is “a conducted with the safety and comfort of the patient in mind. Most people are apprehensive because they’ve been told since childhood that they have this serious allergy. The test is performed by a pharmacist in the outpatient clinic at Holmes.”
Step one involves a simple scratch test, step two is an intradermal injection just under the skin, and step three is an injection of a small dose of amoxicillin. There is an appropriate waiting period after each step to observe the patient and ensure there are no adverse reactions.
The entire process takes 90 minutes.
Sanchez said it’s especially important for expectant moms to know if they have a penicillin allergy. For 30 years, the CDC has recommended expectant moms get a Group B Streptococcus (GBS) screen and prophylactic antibiotic treatment with penicillin.
Why? Because about 1 in 5 pregnant women are colonized by GBS. They risk transmission at delivery that can result in sepsis and death.
“Antibiotic treatment for women colonized by group B strep is an important and routine part of medical care during labor,” said Health First Obstetrician Adam Close, MD. “The ideal antibiotic is formulated with penicillin, but the 10 percent of patients who report an allergy to it are usually treated with alternative antibiotics, which can have more serious side effects. Confirming which patients have a true penicillin allergy will allow us to provide even safer maternity care.”
Sanchez said that anyone facing surgery needs to find out if the penicillin allergy they think they have is real.
A study by Massachusetts General Hospital found that surgical patients believed to be allergic to penicillin were significantly more likely to develop infections than those with no documented allergy. They highlighted that 40 percent of healthcare-related infections in hospital patients occurred at the site of surgical incisions and that such infections could lead to complications and even death.
After adjustment for factors such as age, sex, and the type and duration of surgery, the risk of a surgical site infection was found to be 50 percent higher in patients with a reported penicillin allergy. The only factor clearly associated with infection risk was the type of alternative antibiotic patients received, which was typically less effective than a penicillin-based one would have been.
“These patients have been told all their lives that they’re allergic to penicillin-based antibiotics, and they’re scared of being given anything in that class,” says Sanchez. “What happens then is they don’t get the preferred antibiotic before their operation – they get the second- or third-line antibiotic, and the numbers show a higher surgical-site infection rate.”
Sanchez says there are several reasons why people believe erroneously that they have a penicillin allergy. “Maybe they received penicillin when they were a child and got a rash soon after. But the rash could have been caused by the infection they were fighting. Plus, the majority of people who had the allergy at one time would have outgrown it as years passed. That’s why it’s so important to have this test that we’re so happy to offer to the community.”
He adds, “It’s currently available to adults only. But Holmes is one of the first in the nation to offer it on an outpatient basis.”
To find out more about Health First’s penicillin allergy testing, visit hf.org/allergy-testing.
