The acceptability of a four-part protocol for penicillin allergy testing by practicing allergists
Abstract:Currently, there is no standard protocol to test for penicillin (PCN) allergy since PrePen (manufactured benzylpenicilloyl polylysine; AllerQuest, West Hartford, CT) was discontinued in 2004. Our article reviews allergist's opinions on a protocol to test for PCN allergy in patients without a history of a life-threatening reaction. This study was performed to determine whether fellows of the American Academy of Allergy, Asthma, and Immunology (AAAAI) would use a two-challenge PCN allergy protocol to test for PCN allergy while skin testing to the major determinant, benzylpenicilloyl polylysine, is unavailable. A questionnaire regarding PCN allergy and application of a four-step protocol was sent to 1210 allergists and immunologists. Of the 654 respondents, 324 (49.5%) believed that the protocol was practical in a busy, outpatient allergy practice and 64 (9.8%) wanted more information. One hundred ninety-four (29.7%) did not think it was practical. Two hundred ninety-five respondents (45.1%) then went on to respond that they would apply the protocol in an outpatient practice and 117 (17.9%) were undecided and wanted more information. One hundred thirty-five respondents (20.6%) would not apply the protocol in their practice. Of those who were undecided or did not think it was practical, 58 (8.9%) were awaiting PrePen, 33 (5%) wanted to see a larger protocol, 24 (3.7%) wanted more detail on the challenge, and 14 (2.1%) felt more comfortable desensitizing the patient. Forty-five percent of the fellows of the AAAAI would apply the proposed protocol to test for PCN allergy. Sixty-two percent said they may apply the protocol if a larger study was performed.
Document Type: Research Article
Affiliations: Division of Allergy and Immunology, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, Delaware; Division of Allergy, Thomas Jefferson University, Philadelphia, Pennsylvania
Publication date: March 1, 2009
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