Chronic Hives and Self Reported Penicillin Allergy Often Co-Exist

MedicalResearch.com Interview with:

Dr. Susanna Silverman

Dr. Susanna Silverman

Susanna Silverman, MD
Allergy & Asthma Care of New York 

Medical Research: What is the background for this study?

Dr. Silverman: Approximately 10% of the general population has self-reported penicillin allergy.  Because hives and rash are often attributed to drug allergy, we began to think about certain conditions that may be confused with penicillin allergy.  Chronic urticaria, which is defined as the presence of hives for six weeks or longer, is one such condition.  We were interested in looking at the prevalence of self-reported penicillin allergy in patients with chronic urticaria, and the prevalence of chronic urticaria in patients with self-reported penicillin allergy.

Medical Research: What are the main findings?

Dr. Silverman: Our study found that in patients seen at the University of Pennsylvania Allergy and Immunology clinic, the prevalence of self-reported penicillin allergy in patients with chronic urticaria was approximately three times higher than in the general population.  Similarly, the prevalence of chronic urticaria in patients with self-reported penicillin allergy was three times higher than in the general population. This suggests that in some patients, self-reported penicillin allergy may be due to chronic urticaria, not true drug allergy.

Medical Research: What should clinicians and patients take away from your report?

Dr. Silverman: Given our study’s finding that chronic urticaria and self-reported penicillin allergy frequently coexist, we feel that it is important for clinicians to ask patients with self-reported penicillin allergy about symptoms of chronic urticaria.  In patients with both chronic urticaria and self-reported penicillin allergy, penicillin skin testing can be done if possible, in order to evaluate their current penicillin allergy status.  Because penicillin allergy has increased healthcare-associated costs for both patients and society, including longer hospitalizations and unnecessary use of broad-spectrum antibiotics with associated serious infections, a targeted evaluation of patients with higher than expected rates of self-reported penicillin allergy is important.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Silverman: The next step would be to perform penicillin skin testing for all chronic urticaria patients who self-report penicillin allergy, in order to determine whether or not these patients are more likely to have positive penicillin skin test results.

Citation:

Susanna Silverman, Russell Localio, Andrea J. Apter.Association between chronic urticaria and self-reported penicillin allergy. Annals of Allergy, Asthma & Immunology, 2016; DOI: 10.1016/j.anai.2015.11.020

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Susanna Silverman, MD (2016). Chronic Hives and Self Reported Penicillin Allergy Often Co-Exist 

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