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Dr. Curt Chaffin, MD; member, Chattanooga-Hamilton County Medical Society

Q: My medical chart says I have a "penicillin allergy." Am I really allergic?

A: Up to 10 percent of the U.S. population thinks they are allergic to penicillin, but recent studies show that less than 10 percent truly are. With the increased use of electronic medical records, drug allergies are a part of your medical record likely to be shared with all physicians and hospitals. Once you've been labeled "penicillin allergic," you won't receive penicillin or a related drug.

The label "penicillin allergic" in most people is due to mistaking an adverse reaction such as vomiting or diarrhea for an allergy. It's also possible to confuse an unrelated viral rash as being caused by penicillin. Other people may truly have been allergic to penicillin in the past, but the allergy has gone away over time.

Symptoms of a true allergic reaction can vary from a mild skin rash to a severe chain reaction within the body called anaphylaxis, which can be fatal. Anaphylaxis caused by penicillin allergy is very rare. It's usually not possible to determine penicillin allergy based solely on patient history; a formal evaluation by an allergist is recommended. Penicillin allergy is the most common drug allergy. However, penicillin is also the preferred antibiotic for ear, sinus, chest, throat and skin infections. For those not allergic, penicillin is safe to use during pregnancy and breastfeeding. It's well tolerated in children and is very economical. Your doctor's treatment choices are restricted if you are listed as allergic. The result is less effective, more expensive and more dangerous antibiotics being prescribed.

Penicillin allergy testing involves a simple, minimally invasive and reliable office-based test done by a board-certified allergist. If the tests are negative, you will be given an oral dose of a penicillin drug and monitored for an hour to an hour and a half in the allergist's office. If you are negative on skin testing and do not react to an oral challenge, you may safely take penicillin in the future. A positive skin test or oral challenge would confirm you should not take penicillin.

— Dr. Curt Chaffin, MD; member, Chattanooga-Hamilton County Medical Society

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