Penicillin Allergy: Evaluation and Testing

Over 95% of people labelled as penicillin allergic are not. This video supplement covers 5 toolkits from the January 15, 2019, JAMA clinical review that are a resource for clinicians interested in performing penicillin allergy testing in their practice. This video also explains risk stratification of patients undergoing penicillin allergy testing, patient preparation for testing, testing of low-risk patients and managing reactions to oral penicillin challenge including anaphylaxis, testing of moderate-risk patients, and follow-up management.

0:00 - Introduction
1:22 - Risk Stratification
3:08 - Preparation for All Patients Before Penicillin Allergy Testing
4:38 - Anaphylaxis Kit in Your Clinical Area
5:19 - Testing Low-Risk Patients
7:20 - Management of Anaphylaxis
8:16 - Testing Moderate-Risk Patients: Step 1 - Skin Prick Test
11:46 - Testing Moderate-Risk Patients: Step 2 - Intradermal Test
13:05 - Testing Moderate-Risk Patients: Step 3 - Oral Amoxicillin Challenge
13:59 - Updating EMR
16:30 - Additional Considerations

[JAMANetwork]

0:00 - Introduction
1:22 - Risk Stratification
3:08 - Preparation for All Patients Before Penicillin Allergy Testing
4:38 - Anaphylaxis Kit in Your Clinical Area
5:19 - Testing Low-Risk Patients
7:20 - Management of Anaphylaxis
8:16 - Testing Moderate-Risk Patients: Step 1 - Skin Prick Test
11:46 - Testing Moderate-Risk Patients: Step 2 - Intradermal Test
13:05 - Testing Moderate-Risk Patients: Step 3 - Oral Amoxicillin Challenge
13:59 - Updating EMR
16:30 - Additional Considerations

[mrdgenerate]

I took amoxicillin growing up. I can remember the weird old doctor saying it every time I went to the Dr. It's a weird word so I remembered it. I got strep throat in junior or senior year of high school. We immediately went on sort of vacation in FL. During that vacation I had leg pain so bad I remember walking into a McDonald's and literally had to be carried out by my friend. My calves hurt so bad I literally couldn't walk out. I called it bone pain I didn't know wtf was happening. My friend who carried me out of McDonald's and i were there for our little sisters cheerleading competition and I waited for my mom to get back in my friends parents ground floor hotel room. I was in a lot of pain. Dr said to immediately quit taking the medication. I also had hives up and down both arms days after quitting taking the medication. My grandmother is supposedly also allergic to penicillin. But this video makes me think maybe I'm not anymore. But I'm dumb there's no telling what the internet could convince me of. Maybe that I can fly and will be the first long snapper to get drafted in his 30s. This 5 out of a 100 thing makes me want a retest. Like a real allergy panel. I was 100% allergic then, but now after none for 10+ years who knows.

[lindsayhengehold]

I had to go through this myself for a penicillin allergic reaction more than a decade ago

[ahmedgad]

Thanks a lot, very informative, I hope for more vedios like this one.

[janco]

I have delayed itching from penicillin. 2 to 4 hours after taking a dose. Does that mean i am allergic?

[marcoramirez]

i was getting surgery snd they injected me with penicillin and i grew hives and throat started to close

[RedRedux]

If you have a history of severe delayed reactions to skin prick tests is this safe for penicillin testing? It was three days before my arm was a normal size again last time 🤣