Judy Foreman

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Is there a quick way for doctors to tell if a person is allergic to penicillin?

March 16, 2009 by

No, although at least one is in the works and may be reviewed soon by the US Food and Drug Administration.

Developing a quick penicillin allergy test for emergency room use is seen as long overdue, partly because many people who think they are allergic to penicillin turn out not to be. They could safely take penicillin, an old but highly effective antibiotic, instead of more expensive drugs that are more likely to trigger drug resistance.

In a recent study published in the Annals of Emergency Medicine, researchers from the University of Cincinnati College of Medicine studied 150 emergency room patients and discovered that 90 percent of those who thought they were allergic to penicillin were not.

That determination was made by making a small skin prick and then injecting some penicillin under the skin. Within 30 minutes it was clear whether the person was allergic. This shows that, at the very least, it is feasible for emergency room physicians to test patients for penicillin allergies, says Dr. Joseph Moellman, an emergency department physician who is one of the study’s authors.

The researchers are now trying to determine how much money could be saved by testing patients and using penicillin more often. They estimated that the difference between penicillin-based antibiotics and non-penicillin based antibiotics is roughly $80 per patient.

Dr. Alasdair Conn, chief of emergency services at Massachusetts General Hospital, welcomed the new results, though he cautioned that the findings should be replicated before practices are changed in all emergency departments. Compared to new, more “broad spectrum” drugs, penicillin is “incredibly cheap,” he noted, and as more hospitals switch to computerized systems that examine doctors’ prescription orders, the push to use cheaper drugs will intensify.

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