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Drug Allergy

Occasionally patients may have experienced rashes with antibiotics in the past or even had parents tell them about an allergy they once had, but the details regarding the reaction will be forgotten. Often mild rashes do not indicate a true allergy to a medication, and allergic sensitization to medications can even be lost after several years. If you or your physician would like us to help determine if you can safely receive a specific medication (often an antibiotic) due to questionable past reactions, we will take a careful history to see if you are a candidate for further evaluation. Assuming the reaction was not severe or anaphylactic (usually involving low blood pressure or breathing difficulty) and did not involve any blistering skin reactions, then we may be able to check if you still have an allergy to the medication. If the medication is in the penicillin class of antibiotics (such as amoxicillin), then we will be able to perform commercially available, standardized skin tests that are highly predictive of subsequent allergic reactions.

For non-penicillin antibiotics there are no commercially available standardized skin tests to medications, but skin testing to a liquid preparation of the medication can still provide helpful information. If skin testing is positive, then we will not pursue further evaluation, and you should not receive that medication in the future because you may still have a significant allergy. If skin testing is negative and the history is questionable, then we may offer an in office graded oral challenge in which you take the medication while being observed in our office. Should you be able to tolerate the medication with no reaction for several hours, then it is likely that you have lost the allergic sensitization to that medication, and we will share that information with your doctor.