What actions should be taken once the results of a penicillin skin are known?

Updated: May 16, 2018
  • Author: S Shahzad Mustafa, MD; Chief Editor: Michael A Kaliner, MD  more...
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If penicillin skin testing yields positive results, one must use an alternative antibiotic or pursue a desensitization protocol to penicillin. If skin testing yields negative results, most clinicians recommend giving the first dose of penicillin orally and in an allergist’s office. This can be done immediately following the negative penicillin skin testing.

If penicillin skin testing yields positive results, myriad desensitization protocols are available for penicillin (and numerous other medications). Informed consent must be obtained. Desensitization protocols must be performed in a setting equipped to quickly handle anaphylaxis (generally in an intensive care unit). Protocols generally involve administering 8-12 escalating doses of the medication orally or intravenously every 20-30 minutes while observing the patient for pruritus, flushing, urticaria, dyspnea, hypotension, or any other manifestations of anaphylaxis. If no manifestations are observed, the patient can receive the full dose of the medication.

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