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Penicillin: an assumed allergy is often not an allergy

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Penicillin: an assumed allergy is often not an allergy

Past experience is no proof

Penicillins, also known as beta-lactam antibiotics, are among the antibiotics that have been tried and tested for the longest time and are even given to small children for severe infections.

But many people mistakenly believe they are allergic to penicillins. They conclude, for example, from past experiences that they do not tolerate the drug – because they have reacted with diarrhea, skin reddening or itching, for example. But that’s not proof of an allergic reaction.

Allergie­vermutungen oft unbe­gründet

The mere suspicion of being allergic to penicillin sticks in your mind. However, only about ten percent of suspected cases are actually allergic to penicillin. The Medical Association of German Allergists points this out.

A study published in the specialist publication Jama in 2019 came to a similar conclusion.

Complaints can have other causes

Suspicious symptoms such as a rash are often not a true allergic reaction to penicillin but may be caused by the underlying infection itself. Other medications administered or a concomitant viral infection can also be the trigger. Gastrointestinal symptoms can also simply be a common reaction to antibiotics, as the latter also attack beneficial gut bacteria.

The risk of being affected yourself just because a close relative has a proven penicillin allergy is low.

Other antibiotics are often not as effective

The consequence of an incorrectly suspected allergy: To be on the safe side, many of those affected are not prescribed penicillins, but other antibiotics. This in turn can have disadvantages, because alternatives often do not work as well. They can also have more side effects and increase the risk of resistance.

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Advantages of penicillins: Although they have been used for a long time, they are still very effective – and surprisingly few bacteria have become resistant to them, i.e. have become insensitive. This is due to the fact that the agents often only kill harmful types of bacteria in a targeted manner and spare the others.

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Have the tolerance checked by an allergist

Whether an allergy is actually present can usually be clarified by an allergological practice – for example with a skin test, called a skin prick test. Health insurance pays for the allergy test. It is best to have the test within a year of the suspected allergic reaction to the penicillin. In the case of infection and acute situations such as accidents or operations, the test result can be important.

Penicillin allergy does not have to be permanent

If allergic reactions to certain penicillin preparations occur, it is possible to check whether those affected can switch to other penicillins with a modified chemical structure.

In principle, the tests can be repeated after a few years. Because a drug allergy can disappear years later. After all, 80 percent of those affected become tolerant again after a decade: the allergen that once triggered the reaction no longer bothers them.

Allergic Reactions: From rash to shock

If a penicillin allergy is actually present, the symptoms can occur at different speeds – depending on whether the allergic reaction is immediate or delayed:

In the most severe case, several of the above symptoms appear together; there is a risk of life-threatening anaphylactic shock. If there are warning signs such as swelling of the face and mucous membranes, tachycardia, cold sweat, shortness of breath, dizziness or a circulatory collapse, the emergency doctor (telephone 112) must be called immediately.

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In the event of an allergic reaction, the penicillin is discontinued. The doctor then decides how to continue treatment.

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