Penicillin is a valuable first line of defence against bacterial infection, widely prescribed to prevent mild illness becoming serious illness. But, as with many medications and foods, antibiotics such as penicillin can cause an allergic reaction in some people.
Now, new research reveals that 90 per cent of those who believe they are allergic to penicillin are not.
As a result, many patients could safely take penicillin rather than second-line medications with alternative side-effects that might be worse than the penicillin allergy.
Why do so many wrongly believe they’re allergic to penicillin?
There’s a two-part answer to that question. First, many penicillin allergy diagnoses are made during childhood. And, just as many grow out of other childhood allergies, the same is true in the case of penicillin.
For 80 per cent of patients, if more than a decade has passed since the initial reaction, their allergy will no longer exist. The human body is not a static organism, it changes over time – sometimes, even for the better!
The second part of the answer revolves around misdiagnosis. Many children are ‘diagnosed’ as being allergic because a parent or other family member has an allergy. Dr Winnie Tong, allergy researcher at UNSW Medicine and Health, says: “Penicillin allergy is not inherited.”
Also, other drug side-effects are often mislabelled as allergies. That might seem like splitting hairs but identifying the difference can help produce better, less disruptive treatments.
Reducing the misdiagnosis numbers
Given the extra time, cost and inconvenience associated with implementing a secondary treatment, lowering that 90 per cent figure is important. One of the problems in doing so is identifying which one of the 10 labelled as allergic really are allergic.
A penicillin allergy skin test is available, but that is rather time-consuming and can be painful. However, an oral test has now been developed, and a recent Austin Health trial suggests it could be revolutionary.
The ‘PALACE study’ was a world-first randomised control trial undertaken by a team of North American and Australian specialists. The trial involved 382 adults, each assessed using a specialised tool called PEN-FAST. Participants were randomly assigned to receive either a direct oral penicillin challenge or the standard approach. The latter approach involved penicillin skin testing followed by an oral challenge.
The aim of the trial was to determine if the oral test was as effective as the skin test. The results demonstrated that the direct oral penicillin challenge is just as effective as the standard method.
What are the implications?
According to Austin Health, there are wide-ranging implications. This will be particularly so for over “two million Australians who’ll have access to the simplified penicillin allergy testing procedure”.
“By accurately identifying low-risk penicillin allergy patients, healthcare providers can ensure appropriate antibiotic prescriptions,” an Austin Health news release said.
So, if you’ve been avoiding antibiotics because you think you are allergic, have a chat to your GP. You might be pleasantly surprised to learn that treating an infection is much easier than you previously thought.
Do you believe you have a penicillin allergy? Would you be willing to take the oral test? Let us know via the comments section below.
Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.