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Not all general practitioners, subspecialists understand penicillin allergy

Many inpatient providers do not refer patients with penicillin allergy in their medical history to an allergy specialist, despite the benefit to the patient’s health, according to study findings presented at the American College of Allergy, Asthma and Immunology Scientific Meeting.

Of the 121 advanced practitioners and attending providers in general internal medicine, 99 referred have never consulted an allergist/immunologist or only did so once a year, , despite conceding the need for such a consultation existed in many situations. Sixty of 68 non-internal medicine clinicians and 81 of 87 subspecialty practitioners also reported never consulting an allergist or only doing so once annually.

Allison Ramsey

Dipekka Soni

“The most striking aspect of this study is that despite the known significant public health implications of penicillin allergy, there is very little knowledge about the natural history of penicillin allergy among inpatient providers,” Allison Ramsey, MD, FAAAAI, of Rochester Regional Health in Rochester NY, told Healio Family Medicine. “Penicillin skin testing is a very sensitive test, yet most inpatient providers do not consult allergy/immunology providers for skin testing. Further, there is a significant knowledge gap in appropriately identifying patients for skin testing based on the clinical vignettes in our survey.”

The survey revealed other misconceptions about penicillin, researchers said.

“Less than half of those surveyed understood that a penicillin allergy can resolve over time. Only 20% identified appropriate patients for penicillin skin testing from the descriptions provided,” Ramsey said in a press release.

“Further investigation addressing barriers to appropriate [allergy/immunology] consultation is required,” Dipekka Soni, MD, internal medicine resident at Rochester Regional Health and a study co-author, wrote in the study abstract. – by Janel Miller

Reference: Soni D, et al. A clinical perspective: The prescriber’s true understanding of the ‘penicillin allergic’ patient. Presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting; Nov. 10-14; San Francisco.  

Disclosure: Ramsey and Soni report no relevant financial disclosures.