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Susan’s Story and the Benefits of Getting Tested

When Susan was a little girl, she broke out in hives after taking penicillin. Her doctor assumed she was allergic, and like many patients, Susan carried that label for decades. Now 70 years old, Susan had avoided penicillin her entire life — until recently.

After being hospitalized with pneumonia last year, Susan’s doctors were limited in the antibiotics they could prescribe due to her reported allergy. That’s when her primary care physician, Shira Marder, MD at ����Թ�, encouraged her to undergo penicillin allergy testing.

“I spent almost 70 years thinking I was allergic to penicillin,” Susan says. “For someone my age, being able to take medications with penicillin can make a big difference in my care. It is a very effective drug and also less expensive.”

She went through skin testing and an oral challenge, a process in which small amounts of the drug are administered under close medical supervision. The result? Susan found out she’s not actually allergic to penicillin.

A Common Misconception

Susan’s story is far from rare. According to the Centers for Disease Control and Prevention (CDC), about 1 in 10 Americans report a penicillin allergy. But studies show that up to 90% of those people aren’t truly allergic.

Many are labeled as allergic in childhood after a mild rash or other symptoms that were never fully evaluated. Others may have experienced side effects from an illness itself—like a viral rash—that got mistakenly linked to the antibiotic. And some people simply outgrow their allergy over time.

“Many people carry around a penicillin allergy diagnosis for decades after a reaction they had in early childhood. However, this does not mean they are truly allergic to penicillin. Most reactions (like a mild rash) are benign and go away on their own,” says Joshua Grossman, MD, allergist and immunologist at ����Թ�. “This is why penicillin allergy testing is so important.”

Why It Matters

Avoiding penicillin unnecessarily can have real downsides. When patients are prescribed alternative antibiotics, those medications may:

• Be less effective for the infection
• Have more side effects
• Be more expensive
• Contribute to antibiotic resistance

In Susan’s case, she now has access to one of the most effective and affordable classes of antibiotics. “I keep telling all my friends who say they’re allergic that they should get tested,” she says. “It could end up saving their life.”

What Testing Involves

Penicillin allergy testing typically includes two steps:

• Skin testing – A small amount of penicillin is placed on or under the skin to see if a reaction occurs.
• Oral challenge –A small dose of penicillin is given by mouth while medical staff monitor for any reaction.

“If no symptoms appear, you’re likely not allergic,” says Avi Deener, MD, an allergist and immunologist at ����Թ�. “Your allergist will discuss appropriate testing with you based on risk factors. Tests may include skin testing and/or the slow introduction of the medication also known as an oral challenge under observation.”

“The oral challenge testing was very easy,” Susan recalls. “I sat comfortably in the office for about two hours just reading a book. The doctor was with me at first, and then the nurses — who were wonderful — came in to check on me and track my vitals every 20 minutes. I felt reassured that the doctor was close by if needed. He answered all my questions and thoroughly examined me before I left the office.”

“Reliable testing wasn’t widely available when many of today’s older patients, like Susan, were first diagnosed,” adds Laura J. Mechanic, MD, Allergy and Immunology.

“Now, with proper skin and oral testing, we can safely determine whether someone is truly allergic and potentially open the door to more treatment options. The testing process is easy, convenient and safe.”

What If You Are Allergic?

If testing confirms that you do have a true penicillin allergy, your doctor will help identify alternative treatments. In some cases, desensitization may be an option—a temporary process that allows your body to tolerate the drug for a short period.

Take the First Step

If you’ve been told you’re allergic to penicillin, especially if that diagnosis was made years ago, it may be time to reconsider. Talk to your doctor or schedule an appointment with a ����Թ� allergist to find out for sure.

“Susan’s experience shows that clearing up a misunderstood allergy can open the door to safer, more effective treatment—at any age,” says Dr. Grossman. “Our team is ready to work with patients to help them safely and effectively evaluate their penicillin allergy so they can have the best possible options moving forward.”