PRE-PEN - PENICILLIN SKIN TESTING
Have you ever been told that you may have had a penicillin allergy, but you weren't sure?
Is there a treatment that involves penicillin that you would like to undertake, but you are afraid that you are allergic to it?
Let us help you! We do penicillin testing in our office!
PRE-PEN is the only FDA approved skin test for the diagnosis of penicillin allergy. PRE-PEN is administered through both scratch and intradermal testing and quickly identifies patients who can safely receive penicillin.
It is estimated that penicillin allergy is overstated due to non-confirmed, self-reported patient history. Approximately 85% of patients who describe themselves as penicillin allergic will have negative skin tests and can safely receive penicillin and related antibiotics.1
Confirmation of the presence of a true allergy is critical and non-confirmed penicillin allergy may result in:
- Unnecessary denial of an effective and well tolerated treatment
- Increased out of pocket costs for patients, since many alternatives to penicillins are Tier 3 medications
- Overuse of broad spectrum antibiotics leading to increased drug-resistant bacteria
If the skin testing is negative, we will even have you ingest a penicillin tablet in the office, called an oral ingestion challenge.
Click or call us to schedule your appointment today!
What is PRE-PEN?
- PRE-PEN is the only FDA approved skin test for the diagnosis of penicillin allergy. PRE-PEN is administered through both scratch and intradermal testing, and quickly identifies patients who can safely receive penicillin.
- Allergy to penicillins and related antibiotics is the most commonly reported drug allergy in the United States. Approximately 85% of patients who describe themselves as penicillin allergic will have negative skin tests, and can safely receive penicillin and related antibiotics.
- Penicillin allergy is overstated due mostly to non-confirmed, self-reported patient history. Demonstrating the true presence of penicillin allergy with PRE-PEN can be a critical element in patient care.
Some potential benefits of PRE-PEN penicillin skin testing
- Unnecessary denial of an effective and well tolerated treatment
- Decreased out of pocket costs for antibiotics, since many alternatives to penicillins are costly
- Decrease the overuse of broad spectrum antibiotics which leads to increased drug-resistant bacteria
Some risks and contraindications of PRE-PEN penicillin skin testing
- Rarely, a systemic allergic reaction including anaphylaxis may follow a skin test with PRE-PEN. We take precautions to decrease the risk of a systemic allergic reaction by first performing skin testing.
- Patients known to be extremely hypersensitive to penicillin should not be tested. Also, those who have clear histories of severe skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis, should not undergo penicillin skin testing, since such testing may reactivate their disease.
- No reagent, test, or combination of tests will completely assure that a reaction to penicillin therapy will not occur.
What is the procedure of the PRE-PEN penicillin skin testing?
- Please inform us of your past medical history, all current medications, as well as penicillin allergy history.
- The actual PRE-PEN penicillin procedure involves applying prick skin tests with PRE-PEN in conjunction with Penicillin G, plus positive (histamine) and negative (diluent) controls. If the skin test is negative, we will then apply intradermal tests along with a control.
- Afterwards, we will examine the test sites for the appearance of a wheal and erythema. If the skin testing is negative, we may perform an oral challenge. You will be monitored in the office following the challenge for any reaction. The whole procedure takes about 2 hours.
Which patients are good candidates for penicillin skin testing?
- Any patient with a history of a reaction to a penicillin antibiotic that may have been IgE-mediated.
- Any patient who is currently denied access to beta Lactam antibiotics out of concern for such reactions.
What do I need to do before penicillin skin testing?
- Stop oral antihistamines and steroids for a week before testing, because these medicines will interfere with results.
- Wear a short sleeve shirt, as the penicillin skin testing will be performed on your arms.
