Management and choice of antibiotics for patients with an allergy to penicillin

Allergic reactions to penicillin occur in 0.7-8% of treatments. Management of bacterial infections in patients allergic to penicillin depends on the availability of alternative antibiotics and on the type of allergy. Skin tests can be used to exclude the risk of IgE-mediated reactions (e.g. anaphylaxis) to subsequent penicillin administration. If penicillin is the first choice for treatment and the patient has an IgE-mediated allergy (on the basis of a positive skin test), desensitization therapy to the drug can be performed.