Internal Medicine Journal 38 (2008) 357–367 BRIEF COMMUNICATION Experience with a new commercial skin testing kit to identify IgE-mediated penicillin allergy R. C. Nolan,1 R. Puy,1 K. Deckert,1 R. E. O’Hehir1,2 and J. A. Douglass1,2 1Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital and 2Department of Medicine, Monash University, Melbourne, Victoria, Australia Key words Abstract penicillin allergy, minor determinant, major determinant, cephalosporin allergy. Many patients who describe a history of allergy to penicillin do not prove to be allergic and can be treated safely with penicillin. After a period of 2 years where Correspondence testing of penicillin allergy was not possible, a new commercial kit has recently Jo A. Douglass, Department of Allergy, become available. We report our initial experience with use of the kit with 29 Immunology and Respiratory Medicine, patients and discuss one patient who experienced anaphylaxis during i.d. The Alfred Hospital, Commercial Road, testing. Melbourne, Vic. 3004, Australia. Email:
[email protected] Received 3 May 2007; accepted 15 January 2008. doi:10.1111/j.1445-5994.2008.01657.x Up to 10% of patients attending hospital self-report a A new manufacturer (Diater Laboratories, Madrid, 1 penicillin allergy, although only 10% of these patients Spain) has now made alternative penicilloyl poly-L-lysine (1% total patients) prove to have a true immunoglobulin (PPL) and minor determinant mixture (MDM) available. E(IgE)-mediatedallergy.2 All patients who report a penicillin Preliminary results from Europe show a strong correlation allergy are denied penicillin-based antibiotics and are given to Allergopharma reagents.8,9 Based on these results, we broad-spectrum antibiotics that are more expensive and have recommenced testing of patients referred for inves- may contribute to development of antibiotic resistance.3 tigation of penicillin allergy.