Excessive precaution about antibiotic allergies can have deadly consequences

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An op-ed by family medicine practitioner Victoria Dooley, MD, in today s New York Times discusses the problems engendered when people who say they are allergic to certain antibiotics actually aren t and why this is a deadly problem.

For example, penicillin allergy the most commonly reported drug allergy is self-reported in about 5 to 10 percent of patients. However, in large-scale studies of penicillin skin testing, 85 to 90 percent of these individuals were found to be able to tolerate penicillin. Dr. Dooley addresses why people would say they are allergic to an antibiotic if they aren t. Some people were told incorrectly by their parents that they had an allergic reaction as children. Others experienced a negative side effect such as headache, nausea, or diarrhea after taking an antibiotic and assumed they must be allergic. However, a true allergic reaction where your immune system sees the antibiotic as a threat and overreacts is very different. Symptoms include hives, difficulty breathing, and even anaphylactic shock. And contrary to popular belief, allergic reactions often do not happen the first time someone is exposed to a medication.

Dr. Dooley tells a personal story about why reporting incorrect drug allergies, and thus limiting the number of drugs you can receive, can have fatal consequences. As a resident physician, she had a patient with a superbug infection, who reported a drug allergy to the most effective drug available to treat her a sulfa drug. Although she wasn t sure if she had an actual allergy, the patient reported it just in case, because she thought her sister was allergic to the antibiotic. The patient then had to be given a less effective drug instead. Dr. Dooley writes, Over the course of a few days, my patient deteriorated. Soon she was in the intensive care unit, barely responsive. Within a few short weeks, she died.

Indeed, superbugs pose a serious threat, and infections from these dangerous bacteria are on the rise. And there is not an abundance of drugs available to treat them. Dr. Dooley suggests that if patients are unsure of whether or not they are allergic to an antibiotic, they should discuss their symptoms with their doctor and allow him or her to decide. She concludes, In health care, we often think better safe than sorry. But, when it comes to antibiotic allergies, there can be frightening consequences to erring on the side of caution.

ACSH s Dr. Gilbert Ross added this: This problem is becoming more and more worrisome, as the number of multiple-drug resistant bacteria climbs and the production of new effective antibiotics remains sluggish. Further restricting the therapeutic options needlessly is a recipe for disaster, both for the patient and for the community.