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Comment & Response
November 7, 2017

Persistence of Penicillin Allergy—Reply

Author Affiliations
  • 1Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
  • 2John Hopkins Asthma and Allergy Center, Baltimore, Maryland
  • 3Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
JAMA. 2017;318(17):1714-1715. doi:10.1001/jama.2017.13763

In Reply Our intended primary message was that following careful specialist evaluation, most individuals thought to be penicillin allergic will have negative skin testing and oral challenge, enabling them to be safely exposed to penicillins in the future without fear of an immediate or life-threatening reaction. A recent study suggests 75% of children clinically diagnosed with penicillin allergy have this documented on their health record by age 3 years.1 This childhood label of penicillin allergy imparts both an individual and public health burden that typically goes unchallenged into adulthood. One major reason that most patients carrying a diagnosis of penicillin allergy have negative skin testing and oral challenge and demonstrate future tolerance of penicillin is that only a very small proportion of these patients had ever experienced a true IgE-mediated reaction to penicillins.

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