
Only 1 in 5 people with a penicillin allergy actually had penicillin allergy - DanBC
https://academic.oup.com/jac/advance-article-abstract/doi/10.1093/jac/dky575/5307963#.XF3VSKeIfi9.twitter
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mysterypie
In case you’re wondering how people get falsely labeled as having a penicillin
allergy, I have an anecdote: My grandad with a “penicillin allergy” was
recently treated with a high dose of penicillin for 4 days without any
problem. The hospital didn’t have access to his medical records and also
overlooked what we wrote on the admission forms, and went ahead with
penicillin as the best treatment. I asked my grandad about this allergy. He
said that 40 years ago he had an upset stomach after taking penicillin and the
doctor told him he was allergic. He’s been repeating that information to
doctors and pharmacists for 40 years.

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gpm
I've been told to tell people I have a penicillin allergy.

I've never had penicillin in my life. My sister had a bad reaction when she
was really young and the doctor decided it was safer to just declare I have
one too.

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caymanjim
I had a terrible reaction to penicillin during a bout of mononucleosis. I've
read that it's not uncommon to have a negative reaction to it when you have
mono, and that it doesn't indicate an allergy, so I'm not sure I actually have
an allergy. I never had a problem with it prior to that. It was such a bad
reaction that I don't want to take a chance, though. Every few years, I
explain this to a doctor, and when I give them the details, they usually
respond along the lines of "yeaaaaah, let's keep avoiding that." One of these
days I'd like to get a controlled allergy test for it, but meanwhile, it gets
listed as my only allergy to anything.

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firebird84
All the doctors I meet are generally VERY risk averse. I explain something
similar and they're quite happy to keep avoiding it.

~~~
jazoom
I'm pretty happy to prescribe a medication if a patient wants to give it a go,
as long as the previous reaction wasn't anaphylaxis.

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DanBC
I've submitted this with the title "Only 1 in 5 people with a penicillin
allergy actually had a penicillin allergy". The title in the journal is
"Implementation of a pharmacist-led penicillin allergy de-labelling service in
a public hospital | Journal of Antimicrobial Chemotherapy | Oxford Academic".

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JoeAltmaier
Huh. 98% of those 'de-labelled' went on to have no adverse reaction to
penicillin.

So, what about the 2%? Small study - was that just one person? What was the
reaction? Did they die? It's important to understand the cost of a 'false
negative' here.

At the same time understanding that, NOT treating folks mis-labelled with an
allergy has a cost as well.

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chiefalchemist
Having a allergic reaction once - from a disrupted / suppressed immune system
- and having an actual allergy are two different conditions.

When the majority of the masses falsely believe antibiotics are something you
take for a flu or a cold, then educating them on fluctuations in immunity is
probably too much to expect.

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jazoom
Why would a suppressed immune system increase risk of allergic reaction? I'd
have thought it to be the opposite.

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chiefalchemist
I sit corrected. Thanks. The arc of my point was, the immune system isn't
static. I should have done better. Again, thanks.

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assblaster
What's worse is that these false penicillin allergies have precluded the use
of similar drugs such as cephalosporins, despite a very low cross reactivity,
and worse drugs such as vancomycin were used as substitutes. Thankfully,
increased attention will help to decrease overuse.

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floatingatoll
Never summarize as “allergic” to a medical professional; they need the
details.

I indicate on medical forms that Vicodin gives me waking nightmare
hallucinations, because it doesn’t kill me like an allergy, but they should be
aware of what they’re in for if they do select it. (This straightforward
disclosure has encouraged many years of good decisions by doctors who, I
suspect, would rather not have my screams of terror interfering with their
work :)

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dTal
I'm confused, why do they need the details? You would have had the same result
(no prescription) if you had simply declared yourself allergic.

"Allergic" == "don't prescribe, on pain of death".

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MiddleEndian
In his case, the side effects are hallucinations. Perhaps he's OK with them
being prescribed if the alternative is worse.

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floatingatoll
As a highly intelligent patient, hallucinating nightmares put the hospital
risk from me being highly intelligent and hallucinating. This benefits no one
to call an allergy.

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dr_dshiv
Nice. I've always had to fill in penicillin allergy, but have been skeptical.
Now, more reasons to be skeptical.

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joshschreuder
Yeah same here. My GP recently told me to check the symptoms with family (I
was very young so I didn’t remember) and get administered a dose to test the
allergy now if the symptoms were pretty mild. Haven’t got around to it yet but
I’m thinking I will soon.

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pessimizer
The US and Western Europe are extremely neurotic. All it takes is the mention
that an allergy is possible to have for 20% of people to start claiming that
they have it.

~~~
mysterypie
Like the millions of parents who now think their children have peanut
allergies for flimsy reasons.

