For Patients

Penicillin Allergy

Penicillin allergy is the most commonly reported drug allergy.  About 10% of Americans have a documented penicillin allergy and often the allergy is from a childhood reaction. Penicillin allergy is more common when we look at hospitalized patients or patients with specific diagnoses, such as cancer.  Evaluation of penicillin allergy may include a skin test and/or taking amoxicillin while being observed.

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Other Antibiotic Allergies

The most commonly documented reaction to antibiotics other than penicillins include other beta-lactam antibiotics such as the cephalsoporins. Drugs in this class usually begin with “cef” of “ceph” and the most commonly used of these include cephalexin (“Keflex”) and cefazolin (“Ancef”). These drugs are chemically related to the penicillins and are often avoided in cases of penicillin allergy. Other common antibiotic allergies include allergies to “sulfa” drugs, which usually indicates a history of allergy to sulfonamide antibiotics such as trimethoprim-sulfamethoxazole (“Bactrim”). Other classes of antibiotics we commonly assess include allergies to macrolide antibiotics (for example, azithromycin “Z-pak,” clarithromycin “Biaxin”) and fluoroquinolones antibiotics (for example, levofloxacin “Levaquin” or ciprofloxacin “Cipro”). Although these are the most commonly encountered antibiotic allergies we assess in our practices, we have evaluated patients for all antibiotic allergies, including vancomycin, metronidazole, clindamycin, aztreonam, carbapenem. Evaluation for these antibiotic allergies may include a skin test and/or taking antibiotics while being observed.

Non-Steroidal Anti-Inflammatory Drugs (NSAID) Allergies

NSAIDs cause a variety of reactions including intolerances, side effects, and allergic and pseudoallergic reactions. About 2% of patients report an allergy to NSAIDs. It is important to identify what type of reaction you experienced before taking a related NSAID, which includes aspirin. NSAID evaluation begins with an allergist asking more detailed questions about the reaction and other ingestions and tests may include taking an NSAID while being observed.

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Anesthetic Reactions

Patients who experience perioperative reactions, including reactions to general or local anesthetics, are commonly evaluated by our allergists.  We use skin tests to identify the drug that caused the reaction.  Although we find only about 1/3 of the culprits with skin testing, almost all of the patients we evaluate can return for their operation and receive anesthesia safely. The tests for allergic reactions from anesthesia may include skin tests, blood tests, and taking drugs while being observed.

Chemotherapy Reactions

Patients who experience reactions to chemotherapeutics or biologic agents can be assessed by our team.  Almost all patients can safely receive their indicated (prescribed) treatment. The test for chemotherapy allergy often includes skin tests.  Desensitization procedures allow patients even with severe immediate allergies to receive their treatment safely.  Desensitizations may occur in the inpatient hospital setting.

Multiple Drug Allergies and/or Intolerances

From 1-5% of americans have multiple drug allergies/intolerances.  A long allergy list can get in the way of optimal clinical care.  An allergist will systematically evaluate your allergies and intolerances to clarify the drugs you can and cannot take. Ultimately, many patients who have this evaluation some allergies are able to be removed. 

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Diagnostic Testing

Depending on your clinical history, your evaluation may include only a simple discussion with the allergist.  In many cases, however, there will be testing which may includes skin testing, patch testing, and/or drug challenge testing. Desensitization is also possible if an IgE (immediate) reaction is identified. Speak with your allergist about what is the best evaluation for you.

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