Allergic to Penicillin? What Are the Options?

Disclaimer.  I am not a licensed health practitioner.  This is just another post on an item you might wish to have available if needed so that a physician can treat you and your family as best as possible.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care.  A qualified, licensed physician or other medical provider should be consulted before beginning any herbal or conventional treatment.

Say you are allergic to penicillin.  You've been told this, you believe it, the end.  Is there any reason to go on?

Well, maybe.

Here are some interesting facts:

• Ten percent of Americans report having an allergy to penicillin (and ampicillin and amoxicillin are also members of the penicillin family).
• More than eighty percent of those reporting a penicillin allergy are not truly allergic to penicillin.
• Often the report of an "allergy" is from parents who indicated that the child had a reaction. 
• Often, like with other allergies, the patient outgrows the allergy.
• Even those who displayed a true allergic reaction to penicillin in the past, when tested ten years later exhibited no allergic response.
• Signs and symptoms of a penicillin allergy usually begin within one minute to one hour after taking penicillin.  These may include:
• itching or hives
• numbness or tingling of lips or tongue
• swelling of lips, eyes, mouth, or tongue
• wheezing
• shortness of breath
• difficulty swallowing
• low blood pressure
• fast heart rate
• dizziness 
• nausea and vomiting
• A localized rash and mild nausea are considered a sensitivity and not an allergic response. 
• The only way to really know whether a person is allergic to penicillin is to perform a skin allergy test followed by an oral challenge.  We can DIY the skin test if we have to, but the oral challenge has to be done with medical supervision.  

So what if you think there is a penicillin allergy.  Can't you just take something else?  Does it really matter?

Actually, it might.

What if you or your child has an illness that needs an antibiotic and penicillin is the best choice?  What if, due to whatever circumstances arise, penicillin is the only choice?  Are you going to skip the penicillin because of a supposed allergy?  Now this isn't to mock those who are truly allergic, but just to bring to mind that quite often, as has been stated, more than 80% of people who report having a penicillin allergy are not truly allergic.  If a person is truly allergic, penicillin must absolutely be avoided.  Anaphylaxis is deadly.

Penicillin is a narrow-spectrum antibiotic that is usually very well tolerated and is safe for pregnant and nursing women and children.  The alternatives are often broad spectrum antibiotics which have more side effects and contribute to antibiotic resistance. Clostridium difficile infections actually occur more often in patients who report a penicillin allergy.  With the ever increasing number of antibiotic-resistant bacteria, penicillin is still a useful, and inexpensive, option.  Those who believe they are allergic should really be tested now to find out for sure.

So if a person is truly allergic to penicillin, what are the alternatives?  Well, it is all going to depend on the bacteria that need killing.  There is no one antibiotic that will substitute for penicillin in all cases.  The substitute antibiotic will have to be chosen based on the disease being treated.  In all conditions listed below (and elsewhere), antibiotics will only work on bacterial infections.  They never have and never will work on viral infections.

The following antibiotics should be safe for a person allergic to penicillin to use:

• the macrolide class, which includes erythromycin, clarithromycin (Biaxin), azithromycin (Zithromax), clindamycin
• cephalosporins may be an option.  While the medical myth abounds that up to ten percent of people allergic to penicillin are also allergic to cephalosporins (like cephalexin--Keflex), a review of the medical literature demonstrates otherwise.[1]
• cyclines like doxycycline, minocycline, and tetracycline
• ciprofloxacin
• sulfas like sulfamethoxazole trimethoprim
• metronidazole

Interestingly, there are DIY options that are completely effective and practical for the preparedness minded individual.  We covered that in yesterday's post, in case you missed it.

Links to related posts:  
DIY Penicillin  

For further information:
https://www.verywellhealth.com/cephalosporins-and-penicillin-allergy-83072
https://www.cdc.gov/antibiotic-use/community/pdfs/penicillin-factsheet.pdf
https://medlicker.com/880-allergy-to-penicillin-alternative-antibiotics
https://www.livestrong.com/article/182740-antibiotic-alternatives-for-penicillin-allergies/
https://www.webmd.com/allergies/news/20170206/think-youre-allergic-to-penicillin-check-again
[1] J Emerg Med. 2012 May;42(5):612-20. 
https://pubmed.ncbi.nlm.nih.gov/21742459-the-use-of-cephalosporins-in-penicillin-allergic-patients-a-literature-review/

 24 september 2019