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 Penicillin Allergy

By Hanson, Jill M.D.

Penicillin is an effective medication used to treat bacterial infection.  Alternative medications used in place of penicillin can put you or your child at greater risk of becoming immune to a stronger medication that could be needed to treat infection in the future, such as superbugs.

Boys Town Pediatrics offers allergy evaluation and testing for kids of all ages that have previously been identified as having a penicillin allergy.

What is the benefit of having this evaluation?

Having an evaluation for penicillin allergy will help you determine if you or your child is actually at risk for a dangerous reaction or if it would be safe to take this class of medications. If the evaluation is reassuring, you can feel confident about using penicillin in the future if a doctor feels it is the best treatment for an infection. If the evaluation shows the potential for a dangerous kind of reaction to penicillin allergy, you will know for sure that it has to be avoided.

When will I get the results?

The results of the penicillin allergy evaluation will be known on the same day as your appointment, before you even leave the clinic.  

How long will the evaluation take?

The evaluation can take between 1 ½ and 2 hours.

What is involved in the evaluation? Will it hurt?

Depending on the type of reaction you or your child had, the evaluation might include allergy skin testing and/or an amoxicillin challenge (oral dose of amoxicillin given in the clinic with a 60-minute monitoring period). The allergy skin testing involves four scratch tests (like a sharp fingernail scratching the skin) and three intradermal tests (fluid is injected underneath the very top layer of the skin using a small needle).

If the allergy skin testing is negative, a dose of amoxicillin is given in the clinic and you or your child are monitored for 1 hour. Sometimes, the allergy skin testing isn't needed, especially in children or in adults whose reaction occurred when they were children. In these situations, a very small dose of amoxicillin is given by mouth. If after 10-15 minutes, there is no reaction, a full dose of amoxicillin is given and you or your child are monitored for 1 hour.  

What if my child has a severe reaction?

The risk of a severe reaction during evaluation for penicillin allergy is very low. However, penicillin allergy evaluation is only done in the Allergy Clinic where the doctors and nurses have a lot of experience with treating severe reactions quickly and effectively.

Does insurance cover the cost of this evaluation?

Most insurance plans cover the cost of this one-time visit. If you would like to check with your insurance company about coverage before scheduling an appointment, please contact our billing department.