How do I know if I’m really allergic to penicillin?
AI have always believed myself to be allergic to penicillin, as my mother told me I had a bad reaction as a toddler to an antibiotic. Growing up, doctors and pharmacists were told that they must prescribe me an alternative drug and, to the best of my knowledge, I haven’t had penicillin since. I’m now in my thirties and I’ve been reading lately that many people who believe themselves to be allergic to penicillin are not actually allergic, and that this is dangerous, as other antibiotics are not as effective. It worries me as I age that my options for treatment in a medical emergency are limited. Is it possible that I could have grown
out of this allergy, or that I was never allergic in the first place? Is there a safe way of finding out? TRUE allergy occurs when the immune system responds to a substance that is not normally harmful. It is over-sensitive and releases chemicals, which result in a reaction. A substance that causes such a reaction is called an allergen. A true severe allergy to a substance can result in a condition called anaphylaxis. This is a life-threatening, severe, wholebody reaction that results in swelling of the lips, tongue and airway, difficulty breathing, and changes in the heart and blood pressure, leading ultimately to collapse and a risk of death. It is a medical emergency that requires immediate response and attention.
Penicillin is an important and effective antibiotic and it is well-known that many cases of reported reaction are not in fact a true allergy. Up to 10pc of patients report penicillin allergy when, in reality, the true figure is closer to 1pc to 5pc in 10,000 doses prescribed.
Discussing the symptoms you had with your GP may clarify whether there is in fact have an allergy at all or whether it is sensitivity or another medical condition. If there was a definite reaction, such as a rash clearly caused by the substance, or there was wheeze, shortness of breath or collapse, then it is highly likely that there is a serious allergy to the allergen. There are also other forms of penicillin allergy that result in skin and blood changes or kidney issues. Penicillin will also usually be avoided in these cases.
If symptoms appear later in the course of penicillin, it is less likely to be a true penicillin allergy. For example, those who have glandular fever may develop a rash if given amoxicillin, which is a form of penicillin. These people are not reacting to the penicillin, but rather the drug triggers another immune response with the virus.
If the history of reaction is definite, but vague in detail, it is usually recommended to avoid taking
My 76-year-old mother has just been diagnosed with congestive heart failure, but the doctor did
not seem to be overly concerned. What is the outlook for heart-failure patients at her age?
Hpenicillin unless the situation is clarified. Detailed allergy testing involves blood and skin patch tests or more detailed immune assessment. We have some excellent immunologists working in the public sector in
eart failure means the pump action of the heart becomes insufficient to meet the needs of the organs and tissue of the body. The amount of blood pumped by the heart becomes inadequate to circulate through the entire body and lungs. This causes pressure along the vascular system, leading to fluid leaking from our smallest vessels, called capillaries. This pooling of fluid causes symptoms such as shortness of breath, weakness, and swelling, particularly of the limbs.
There are many causes of heart failure. Most commonly it is associated with underlying Ireland but unfortunately waiting lists are long. It is important that if allergy-testing is undertaken it is done by a specialist in a proper clinical environment where all the appropriate resuscitation equipment is available
cardiovascular disease or high blood pressure. Other causes include chronic alcohol abuse, valve issues and various infective causes. Heart failure is classified into four main types (the New York Heart Association Functional Classification), largely looking at a patient’s activity and symptoms. Outlook varies greatly among these types.
The goal of treatment in heart failure is to keep the heart beating as efficiently as possible. Medication will be prescribed to decrease fluid within the body and to help the heart pump more effectively. Lifestyle management such as restriction of salt and fluid
If you have any health queries for Dr Nina Byrnes,
please email Please note that
Dr Nina cannot enter into
individual correspondence should anaphylaxis occur. There are people in whom skin-allergy testing may be dangerous and even bring on a fatal allergic response. Formal allergy testing is usually recommended in those who have had a clear anaphylactic-type response. Blood or skin testing is then often followed by exposing or challenging with the drug to clarify the extent of sensitisation.
As penicillin allergy testing is an intensive and specialised process, priority is usually given to those who have a chronic disease that may require more frequent or chronic antibiotic use. If you are not within this group, testing may not be warranted.
I would advise clarifying the nature of your initial reaction. Discuss this with your GP, who can decide whether referral for further testing is indeed warranted.
intake, avoidance of excess alcohol, stopping smoking and avoiding obesity are extremely important as all of these things put a further strain on the vascular system. Those who are diagnosed early in the disease will fare better than those with a later diagnosis. A recent study suggested that about 50pc of those diagnosed with congestive heart failure are alive five years after diagnosis. Many cardiology centres have specialised heart failure clinics and involvement in these will improve outlook and management, ultimately keeping your mother well for as long as possible.
Ask all three to communicate with each other, and to work together as a team, or else you could be interfering with your progress. Set out a detailed plan and set some time limits and targets, even if it is only walking a few steps.
In my opinion, the most important of all is your mental approach — you have to believe and accept that you are going to make a complete recovery, no matter what the medics say.
Detailed allergy testing involves
blood and skin patch tests