A rational approach to the detection and management of penicillin allergy with report of four cases

ABSTRACT

Four cases of penicillin allergy depicting the immediate as well as the delayed hypersensitivity reactions are presented. The first three cases are considered life-threatening hypersensitivity reactions to penicillin and the fourth case is as occupational allergic reaction to penicillin. The problems of penicillin allergy, which are mostly detection and confirmation of penicillin are discussedIn the final analysis, the practitioners only recourse is the use of benzylpenicillin as a skin test antigen and his ability to elicit a good allergic history. An obvious history of immediate hypersensitivity reaction to penicillin or an apparent major allergic disease cancels the doing of skin test and giving of penicillin to these patients. If there is doubt as to the status of penicillin allergies of the patient and if the use of penicillin is highly indicated, skin test must be performed. A positive skin test should be taken for its face value. However, a negative skin test gives no complete guarantee that allergic reaction will not take place. This particular void can be diminished further by the collaboration of other in vitro tests mentionedGeneric and trade names of drugsPrednisolone and chlorpheniramine - HistacortErythromycin - ErythrocinPrednisolone succinate - Diadreson F. AquosumPotassium phenoxymethyl penicillin - Sumapen VKBenzyl benzoate - BenzophedCrystalline procaine penicillin, G crystalline penicillin G potassium and streptomycin - Pen-Strep (41)Dexamethasone - Oradexon (Summary)