Penicillin allergy test. Necessary or unnecessary?

Abstract

Context: Drug reactions frequency increases with repeated exposure to medications, and it is more common in adults than in children. Hypersensitivity reactions have different characteristics from those not responding to immunological mechanisms. They are related to the known pharmacological effects of the drug; therefore, they are predictable. Currently, this happens to approximately 10% of the population. Objective: To analyse the effects of penicillin in different patients, through scientific literature sources. Methodology: The documentary analysis of different scientific sources referring to patients who presented allergies to penicillin, was carried out. Results: Low-risk medical records include isolated non-allergic symptoms, such as gastrointestinal distress, or patients having penicillin allergies family history. The female sex has been identified as a risk factor in adults for both self-reported and confirmed penicillin allergy. There appears to be no significant relationship between atopy and the incidence of penicillin allergy. A positive result is an indicator of allergy, provided that the concentrations used are proven not to be irritating. A negative result does not exclude medication allergy. The skin testing for excluding or confirming an IgE-mediated mechanism is considered positive when a rash, or skin rash and erythema, appears after intradermal injection. Conclusions: The predictive value of skin testing with drugs, mainly penicillin, is uncertain. It is ubiquitous for this test to be performed on people with no history of reaction to penicillin. This procedure makes no sense, since in an individual with no medical history of hypersensitivity, the possibility of having a serious reaction to this drug is improbable. (0,004% a 0,015%).