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Penicillin-induced anaphylaxis

Fatal penicillin-induced anaphylaxis, first noted in 1949, is believed to cause 100 to 500 deaths per year, with a non-fatal anaphylactic incidence rate of 0.7% to 10% [1, 2]. The fact that both Hollister-Stier and Allergopharma ceased the production of penicilloyl-polylysine (PPL) and minor determinant mixture (MDM) in 2004 is severely hampering the diagnosis of beta-lactam hypersensitivity and may produce negative consequences[3]. Skin testing with benzylpenicillin can partially compensate for PPL and MDM unavailability. Moreover, it can slightly increase the allergologic workup's sensitivity and therefore reduce the number of potentially dangerous challenges[3]

References

1. Wasserman SI: Anaphylaxis in Middleton E, Reed CE, Ellis EF (eds).:

2. Allergy Principles and Practice. 2nd Edition, St. Louis, CV Mosby,

1983. pp. 689-699.

3. Romano A, Bousquet-Rouanet L, Viola M, Gaeta F, Demoly P, Bousquet PJ. Benzylpenicillin skin testing is still important in diagnosing immediate hypersensitivity reactions to penicillins. Allergy. 2009 Feb;64(2):249-53. Epub 2009 Jan 7