Penicillin allergy: a practical approach to management.

Although penicillin is nontoxic, it is highly immunogenic and is the most common drug that causes allergic reactions. A previous reaction to penicillin has been shown to be unreliable in predicting sensitivity in 75% to 90% of patients. To more accurately test for penicillin allergy, diagnostic skin test reagents have been developed; these include the major determinant (benzylpenicilloyl-polylysine) and the minor determinant mixture (penicillin G potassium, benzylpenicilloate sodium and benzylpenicilloyl-N-propylamine). Penicillin skin testing has been shown to be safe and useful in predicting immediate IgE-mediated reactions (overall predictive value 99%). Reactions that occur when patients are challenged with penicillin are mild or accelerated urticarial reactions. We outline a practical and rational therapeutic approach based on the current understanding of penicillin allergy.     

38例自诉青霉素过敏患者再用药体会

目的：探讨自诉有青霉素过敏史患者再次应用青霉素治疗的可行性。方法：对38例自诉青霉素过敏患者再次应用青霉素治疗。结果：38例自诉青霉素过敏患者再用药,35例未出现青霉素过敏反应。结论：有青霉素过敏史的患者可以酌情皮试,阴性后可以应用青霉素。     

Penicillin encephalopathy

Five patients who developed characteristic myoclonic twitching, drowsiness and convulsions due to intravenous penicillin and cloxacillin are described. Three had poor renal function. Twenty-three reported cases of penicillin encephalopathy are reviewed and the aetiology of the syndrome is discussed.