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September 12, 2001

How Predictive Is a History of Penicillin Allergy?

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(10):1174-1175. doi:10.1001/jama.286.10.1173

To the Editor: Dr Salkind and colleagues1 have summarized the limited available literature regarding penicillin allergy. In one of their scenarios, they conclude that a patient with group A streptococcal pharyngitis "should receive penicillin" despite a history of an erythematous eruption in association with a prior course of penicillin. Although the authors may be correct in concluding that testing for an immediate (ie, type I) reaction to penicillin is not necessary, this is only true if the assumption is correct that the prior eruption was not urticaria. I challenge this assumption as it is based solely on a history of an eruption occurring 3 years earlier, beginning "after taking about half a penicillin prescription for a respiratory tract infection" and recalled to be "bright red in color, restricted to the extremities and trunk," and resolving "several days after penicillin was discontinued."

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