geoffrey modest medical blogs

interesting study of patients who report prior history of penicillin allergy (see penicillin allergy skin testing j hosp med 2013 in dropbox, or DOI 10.1002/jhm.2036). 146 hospitalized patients with history consistent with IgE-mediated penicillin allergy were given penicillin skin testing (PST), which consisted of intradermal testing and, if negative, followed by test dose of oral penicillin.  they excluded patients with history of anaphylaxis. only one patient had a positive skin test. the remaining 145 with negative PST did fine with full course of oral penicillin. so negative predictive value of 100%. the results in this study, with <1% having positive PST, is lower than in some other studies, where it is as high as 20%. study significant because there are many patients with history suggestive of IgE-mediated penicillin allergy (eg, hives, urticaria, laryngeal edema, ...). the more specific the patient is about these symptoms, the more likely they have a true penicillin allergy,

interesting study of patients who report prior history of penicillin allergy (see penicillin allergy skin testing j hosp med 2013 in dropbox, or DOI 10.1002/jhm.2036). 146 hospitalized patients with history consistent with IgE-mediated penicillin allergy were given penicillin skin testing (PST), which consisted of intradermal testing and, if negative, followed by test dose of oral penicillin.  they excluded patients with history of anaphylaxis. only one patient had a positive skin test. the remaining 145 with negative PST did fine with full course of oral penicillin. so negative predictive value of 100%. the results in this study, with <1% having positive PST, is lower than in some other studies, where it is as high as 20%. study significant because there are many patients with history suggestive of IgE-mediated penicillin allergy (eg, hives, urticaria, laryngeal edema, ...). the more specific the patient is about these symptoms, the more likely they have a true penicillin allergy,