What Is Penicillin Allergy?

Penicillin belongs to the beta (ß)-lactam antibiotic class, which is commonly used to treat skin, ear, sinus, and upper respiratory tract infections since it is generally successful at eradicating common bacterial infections. Penicillin and penicillin derivatives such as ampicillin and amoxicillin, as well as cephalosporins, monobactams, carbapenems, and ß-lactamase inhibitors, are included in this class of antibiotics. Penicillin, like most drugs, has common side effects and adverse reactions. A penicillin allergy is an immune system reaction to the antibiotic penicillin. Since the 1940s, penicillin has been the go-to antibiotic for bacterial infections, however, some people have a negative reaction to it.

Hives, redness, and itching are common indications and symptoms of penicillin allergy. Anaphylaxis, a life-threatening illness that affects numerous body systems, is one of the most severe reactions. The bacteria that make you sick are supposed to be fought by your immune system, however, your body can sometimes fight the medicine. If you are allergic to penicillin, this is what happens. It’s an invasion of your immune system, and it’s trying to get rid of it. Penicillin allergies may be over-reported, according to research, which can lead to the administration of ineffective and expensive antibiotic therapies. When penicillin allergy is suspected, an accurate diagnosis is required to offer the best treatment options in the future. Other antibiotics, especially ones with comparable chemical properties to penicillin, might cause allergic responses as well.

Symptoms of Penicillin Allergy

Penicillin allergy symptoms usually appear within an hour of taking the medicine. Reactions can happen hours, days, or weeks later in rare cases. The following are some of the indications and symptoms of a penicillin allergy:

• Rashes on the skin
• Hives
• Itching
• Fever
• Swelling
• Breathing problems
• Wheezing
• A stuffy nose
• Eyes that are itchy and watery

Anaphylaxis

Anaphylaxis is a life-threatening allergic reaction that results in extensive body system malfunction. Anaphylaxis symptoms include:

• Nausea or stomach pains
• Diarrhea or vomiting
• Lightheadedness or dizziness
• The pulse becomes weak and fast.
• Blood pressure drops
• Seizures
• Consciousness loss
• Tightening of the airways and throat, resulting in breathing difficulties

Delayed Reactions Resulting from Penicillin Allergy

Penicillin allergy reactions that are less common can happen days or weeks after you’ve been exposed to the antibiotic. They can also last a long time after you’ve stopped using it. Among them are the following:

Serum Sickness

Fever, joint discomfort, rash, swelling, and nausea are symptoms of serum sickness.

Drug-Induced Anemia

Anemia caused by drugs is a decrease in red blood cells that can cause exhaustion, irregular heartbeats, shortness of breath, and other symptoms.

Drug Reaction with Eosinophilia and Systematic Symptoms (DRESS)

Rashes, elevated white blood cell counts, general swelling, enlarged lymph nodes, and the reappearance of dormant hepatitis infection are all signs of drug response with eosinophilia and systemic symptoms (DRESS).

Stevens-Johnson Syndrome

Also known as toxic epidermal necrolysis, this is a skin condition that causes severe blistering and peeling.

Nephritis

This is an inflammation of the kidneys that can produce fever, blood in the urine, overall edema, confusion, and other symptoms. You can also encounter adverse effects from penicillin that are not an allergic reaction to the antibiotic, just as you might with other prescriptions. Mild nausea or diarrhea, headache, or vaginal itching are all frequent adverse effects of penicillin, depending on the variety. Symptoms of an infection for which you are being treated, as well as unrelated symptoms, can be misinterpreted as an allergic medication reaction.

What Causes Penicillin Allergy?

Penicillin allergy develops when your immune system becomes hypersensitive to the antibiotic, mistaking it for a hazardous substance and treating it as if it were a viral or bacterial infection. Penicillin must be exposed to the immune system at least once before the immune system becomes sensitive to it. Your immune system creates an antibody to penicillin if it misidentifies it as a dangerous agent. The next time you take the medicine, these antibodies will recognize it and direct your immune system to destroy it. The symptoms of an allergic reaction are caused by chemicals generated by this process.

Risk Factors of Penicillin Allergy

While anyone can have a penicillin allergy, there are a few variables that can make you more susceptible. Among them are:

• Allergic reaction to another medication
• A drug allergy in the family
• Penicillin exposure has increased as a result of high doses, repeated use, or prolonged use
• Certain illnesses, such as HIV infection or Epstein-Barr virus infection, are frequently associated with allergic drug reactions
• Other allergies, such as food allergies or hay fever that may have been present in the past.

How to Diagnose Penicillin Allergy

An allergist/immunologist can assess penicillin allergy by taking a thorough history and performing skin testing. This test consists of pricking the skin with two types of penicillins (each of which mimics the types of penicillin found in the blood when a patient takes the drug) and then performing an intradermal test (placing a small amount of each form of penicillin just under the skin). If these tests come back negative, it is unlikely that you have a penicillin allergy. In many cases, after negative testing, an oral penicillin dose is administered, followed by an observation period. If there is no reaction, the patient is not at risk of a serious immediate reaction, and penicillins can be used after that. It usually takes 2 to 3 hours to complete all of the testings. In the event of a positive penicillin test, either the skin prick or intradermal test will produce a red, raised bump, indicating the presence of a medication allergy. Penicillins should be avoided, and infections should be treated with a different antibiotic. If penicillin is required, a desensitization procedure can be performed under the supervision of an allergist/immunologist to allow the drug to be used temporarily.

How to Treat Penicillin Allergy

Penicillin allergy treatments can be classified into two categories:

• Treatment for allergy symptoms that are currently present
• Penicillin desensitization

How to Take Care of Present Symptoms

The following treatments may be used to alleviate the symptoms of a penicillin allergy:

• Withdrawal of the Drug: If your doctor concludes that you have a penicillin allergy or a suspected allergy, the first step in treatment is to stop taking the antibiotic.
• Corticosteroids: Inflammation associated with more serious reactions can be treated with either oral or injectable corticosteroids.
• Anaphylaxis Treatment: Anaphylaxis necessitates an urgent epinephrine injection, as well as hospitalization to keep blood pressure stable and respiration supported.
• Antihistamines: An antihistamine, such as diphenhydramine (Benadryl), that can block immune system chemicals activated during an allergic reaction may be prescribed by your doctor or recommended over-the-counter.

Drug Desensitization

If no alternative antibiotic treatment choices are available, your doctor may suggest a procedure called drug desensitization, which allows you to take a course of penicillin to treat an infection. This treatment involves starting with a very tiny dose and gradually increasing it every 15 to 30 minutes over the period of several hours or days. If you reach the appropriate dosage without experiencing any side effects, you can continue with the treatment. To maintain your tolerance to the drug over the length of treatment, it’s critical to take it exactly as prescribed. Note that you will need to repeat the desensitization treatment if you require penicillin in the future.

Now that you Know…

Penicillin is a member of the beta (ß)-lactam antibiotic family, which is commonly used to treat skin, ear, sinus, and upper respiratory tract infections since it is generally efficient at eradicating common bacterial infections and is reasonably inexpensive. Anaphylactic reaction is the most severe type of penicillin or other antibiotic allergies. This can be life-threatening if left untreated, thus it’s a medical emergency. Angioedema can also be life-threatening if the allergic reaction causes airway blockage. However, once the offending agent (penicillin or other suspected antibiotics) is stopped, most allergic responses subside. They aren’t life-threatening, but they can cause a lot of pain for the patient.