Penicillin Allergy: Do You Really Have It?

Penicillin is a frequently prescribed drug for bacterial infections. However, it can lead to an allergic reaction in certain individuals, causing symptoms like hives, itching, or a rash. If you are allergic to penicillin, it is crucial that you seek immediate medical attention.

In more severe cases, anaphylaxis can occur as a result of a penicillin allergy. This life-threatening condition may be characterized by extremely low blood pressure, difficulty breathing, dizziness, a swollen tongue or throat, seizures, vomiting, diarrhea, or abdominal cramps.

If you’re looking to learn more about penicillin allergy, you’re in the right place. This article possesses all the necessary information you require.

What Is a Penicillin Allergy?

Penicillin has been a popular drug for treating bacterial infections since the 1940s, but some individuals may experience adverse reactions upon taking it.

If a person’s immune system responds negatively to the antibiotic drug penicillin by exhibiting certain symptoms, it means he has a penicillin allergy. 

What Are Common Types of Penicillin?

In the field of pediatric medicine, penicillins are one of the most highly utilized antibiotics that are classified into five primary categories.

• Natural Penicillins

Penicillin V potassium is part of the natural penicillin, a group of antibiotics similar to penicillin G that were some of the earliest antibiotics used to treat bacterial infections.

Their mechanism of action is to prevent cell wall synthesis, which causes bacterial death. They are most effective against gram-positive bacteria and some gram-negative bacteria. 

• Aminopenicillins

Similar to natural penicillins, aminopenicillins prevent the synthesis of bacterial cell walls. However, they can target a wider range of bacteria. Aminopenicillins are effective against most gram-positive bacteria, enterococci, and some gram-negative bacilli, including H. influenza and E. coli.

• Broad-Spectrum (antipseudomonal) Penicillins

Antipseudomonal penicillin is a type of antibiotic that has similar antibacterial effects as aminopenicillins. It also has added effectiveness against certain Pseudomonas, Enterobacter, and Serratia species.

These antibiotics are often taken alongside beta-lactamase inhibitors, just like other penicillins.

• Beta-Lactamase Inhibitors 

Certain bacteria generate an enzyme called beta-lactamase that renders beta-lactam antibiotics ineffective. To combat bacterial resistance to these antibiotics, beta-lactamase inhibitors are used.

These medications are usually combined with penicillin antibiotics to prevent them from breaking down, ultimately boosting their effectiveness. However, beta-lactamase inhibitors do not possess any antibacterial properties when used alone. 

• Penicillinase-Resistant Penicillins

Penicillinase-resistant penicillins are a type of penicillin mainly utilized to cure penicillinase-producing methicillin-sensitive Staphylococcus aureus. They are also effective in treating infections caused by Streptococcus pneumoniae and group A streptococcal bacteria.

Penicillin Allergy Symptoms

Common signs of an allergic reaction to penicillin usually include swelling of the skin, redness, itching, or rash. However, if someone experiences severe issues like breathing difficulties, swelling of the face, throat, or tongue, wheezing or cough, difficulty speaking, dizziness, or collapse after taking penicillin, it may be a case of anaphylaxis. 

If the person has an EpiPen, use it immediately and call an ambulance. If the patient has become unresponsive or not breathing normally, try to give him CPR.

How Is a Penicillin Allergy Diagnosed?

To ensure an accurate diagnosis, it is crucial to have a comprehensive examination and appropriate diagnostic tests. If a penicillin allergy is misdiagnosed, it may lead to the use of less-effective or more costly antibiotics.

During your visit with the doctor, they will perform a thorough physical examination, inquire about your symptoms, and request additional tests as necessary. In some cases, you may be referred to an allergy specialist (allergist) for these tests. These tests may include:

• Skin Tests

To determine if you are allergic to penicillin, an allergist may perform a skin test. During this test, a small amount of the suspect penicillin is injected into your skin with a tiny needle.

If you have a positive reaction, you may experience a red, itchy, raised bump. A positive result from the skin test indicates a high probability of a penicillin allergy. 

• Graded Challenge

In cases where there is uncertainty regarding a penicillin allergy diagnosis, the doctor might recommend a graded drug challenge. The process involves giving a maximum of five doses of the suspected penicillin, beginning with a small amount and gradually increasing it to the intended dosage.

If you reach the therapeutic dose with no adverse reactions. In that case, your doctor will conclude that you are not allergic to that particular type of penicillin, and you will be able to take the medication as prescribed.

How Is a Penicillin Allergy Treated?

If you experience mild reactions to penicillin, discontinuation of the drug or the use of antihistamines to treat the symptoms is the best option. However, if the reactions are more severe, prescription medication may be necessary.

There are various other treatment approaches to cure a penicillin allergy:

• In case of an allergic reaction, your physician may suggest antihistamines, such as diphenhydramine (Benadryl), to block the immune system chemicals that trigger the reaction. 
• For more severe reactions, corticosteroids can be prescribed either orally or through injection to manage inflammation. 
• If you experience anaphylaxis, immediate epinephrine injection is necessary, and hospital care is required to maintain blood pressure and support breathing.

Are You Actually Allergic to Penicillin?

Final Thoughts

If you experience a reaction after taking penicillin, seek immediate medical attention by contacting your local emergency services or your healthcare provider, as a penicillin allergy can be severe and life-threatening. 

However, in some instances, patients usually outgrow their allergies or find other alternative antibiotics that might suit them.

FAQs:

Is Azithromycin a Penicillin Allergy?

It is important to note that Azithromycin does not have penicillin in its composition. A medical study confirmed that patients with penicillin allergy did not experience any adverse effects after taking Azithromycin.  Nonetheless, it is recommended to consult with your healthcare provider if you have any concerns. 

Is Ceftriaxone Safe for Penicillin Allergy?

For patients with penicillin allergy, ceftriaxone can be used as an alternative to penicillin G for treatment. And it is generally considered a safe option to go for.

Can I Take Augmentin If I’m Allergic to Penicillin?

If you have an allergy to penicillin, it is important to avoid all medications belonging to this group of antibiotics. And Augmentin is also included in this class.

It is worth noting that if you are allergic to one type of penicillin, you will most likely be allergic to other types within the same class. However, consulting your doctor is always right if you are unsure about what you are particularly allergic to.