In August 2017, we published an article by Vyles et al. (10.1542/peds.2017-0471) who reported on a cohort of children whose parents reported their children having penicillin allergy on a questionnaire but with low risk symptoms. This cohort of 100 children were subsequently tested for penicillin allergy and determined not to have it, with the paper offering an approach to de-labeling low risk children with penicillin allergy so that they might use it as first line treatment when the situation arises. So what happened in the year after these children were tested? Did any receive penicillin or a penicillin derivative and did any complications occur? Vyles et al. (10.1542/peds.2017-3466) return this week with a follow-up of their 100 children who tested negative for penicillin and find that while 46 prescriptions were written for 36 patients based on surveys to parents and their primary care providers, no child developed any serious adverse reactions (although one child developed a rash 24 hours after starting on the medication). Most importantly, the authors cost out the potential savings of de-labeling low-risk patients as penicillin allergic and find that savings substantial. Check out both articles to better understand which of your patients might be worth de-labeling despite parental concerns and share with us your reaction. Would you retry penicillin in patients considered by the authors to be low-risk? Feel free to share your thoughts with us by responding to this blog or posting a comment on our website or on our Facebook or Twitter pages.
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Following Up on Children Who Reported Having a Penicillin Allergy but Who Tested Negative
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Following Up on Children Who Reported Having a Penicillin Allergy but Who Tested Negative
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April 27, 2018
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