Penicillin Skin Testing Specialist

North Texas Allergy and Asthma Associates

Allergists located in Dallas, TX & Plano, TX

If you’re concerned you have a penicillin allergy, but want to know for sure before risking an allergic reaction, seek help from the North Texas Allergy & Asthma Associates team to learn more about skin testing. They can help patients identify their reaction using Pre-Pen skin tests in a safe way. Call or schedule an appointment online to visit any of their locations in North Texas: Texas Health Dallas, Baylor Regional Medical Center at Plano, and Baylor University Medical Center at Dallas.

Penicillin Skin Testing Q & A

Are you at risk for a penicillin allergy?

While you can’t predict a penicillin allergy, a few factors increase the chance that you’re susceptible, including:

  • History of other allergies
  • Allergic reaction to another drug
  • Family history of drug allergy
  • Exposure to high doses of penicillin
  • HIV or Epstein-Barr virus

Penicillin refers to a group of antibiotics. If you’ve had an allergic reaction to one in the group, you may be allergic to the others. A few examples are:

  • Amoxicillin
  • Ampicillin
  • Dicloxacillin
  • Oxacillin
  • Piperacillin
  • Ticarcillin

Who needs penicillin skin testing?

Anyone who has a potential allergy to penicillin should have a skin test to verify the allergy prior to taking drugs in the penicillin family. The most common symptoms of penicillin allergy include hives, rash, and itching, so be sure to tell the doctors if you’ve experienced any of these symptoms after taking penicillin.

Even if you’ve been tested in the past, the doctors at North Texas Allergy & Asthma Associates may recommend having another skin test because many people lose the allergy over time. The bottom line is that it’s essential to know whether you can safely take penicillin, so if there’s any question, you’ll need a penicillin skin test.

How is penicillin skin testing performed?

A small amount of penicillin is dropped onto your arm, then the skin is pricked with a needle, but not deeply enough to draw blood. If you’re allergic, mast cells in the skin will recognize penicillin as an allergen and trigger an immune response — within 15-20 minutes a red, raised spot will appear where the skin was pricked. If the mast cells aren’t activated by the penicillin, you won’t get a reaction and the test is negative.

If the skin prick test is negative, it’s usually followed by a second skin test to verify the results. In the second test, a small amount of penicillin is injected into the skin, then the site is checked 15-20 minutes later to see if there was a reaction. If both tests are negative, you’re not allergic. If there’s any doubt about either one, further tests may be required.  

If you have a positive test, you may still be treated with penicillin by going through a desensitization process. By receiving very small doses of penicillin every 15-20 minutes for about 4 hours, you’ll be desensitized enough to be treated with one normal course of penicillin. However, desensitization doesn’t last, and once you stop taking that course of penicillin, you’ll have the same allergic reaction if you ever take it again.

What to do before your visit:

Premedication 1 day prior and the morning of the procedure.

•Histamine (H1) Blocker: Options include Claritin 10 mg, or Zyrtec 10 mg, or Allegra 180 mg once a day

•Montelukast (Singulair) 10 mg once a day

•Take both pills at the same time each day if possible

Medication Time:

Time recommendedDay 1  Day before CIT Premedication TimeDay 2 Day OF CIT Premedication Time
8:00 AM  

How long will it take:

•The CIT protocol takes 1 - 2 hours in the clinic.

•There is a 30 min wait in between injections and a 1 hour wait after the last injection.

•You can do CIT up to 2 times a week, with 48 hours in between each CIT

What to bring on the day of the visit:

•Books, activities, laptop, etc.

•Wear a half sleeve or sleeveless shirt

•Have a light breakfast the morning of the procedure

•Have a light snack before the procedure

What we will do the day of the visit

•Make sure your asthma, if present, is under good control.

•Obtain baseline spirometry - FEV1 above 70%

•No B-blockers, ACEI, or evidence of cardiovascular disease

•Ensure we have Informed consent in chart

What happens after CIT:

•For most patients, the final dose received during CIT will be repeated for the first post-CIT injection the week after.

•For patients who experienced a systemic reaction during CIT, the first post-CIT dose will be lowered.

•Following CIT, the regular IT schedule will be followed going forward.

•Generally if you tolerate the whole protocol you will continue on weekly injections for another 6-8 weeks, then we can proceed to every other week shots for 6 weeks, followed by every 3 week shots for 6 weeks then monthly.

Insurances Accepted

View list of insurances, Please call the office if you have any questions.

Aetna
Anthem Blue Cross Blue Shield
Cigna
Coventry
Health Net
Humana
Medicare B
Multiplan
Tricare
UMR
United Healthcare
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