Previously, PCN related antibiotics such as cephalosporins were avoided given concern for cross-reactivity. Most severe reactions occur between the ages of 20 to 49 years. Risk factors for IgE mediated reactions include high-dose parenteral administration and repetitive or frequent dosing of penicillins. Serious allergic reactions to penicillin are Type 1 and mediated by IgE. Type 1 and type 4 hypersensitivity reactions mediate the most common allergies to penicillin. Included in the penicillin family of antibiotics are penicillin G, penicillin V, procaine penicillin, benzathine penicillin as well as over 15 related compounds with broader antibacterial effects. This activity reviews the pathophysiology of penicillin allergy and highlights the role of the interprofessional team in the management of these patients. Identification of true penicillin allergy is critical as 80% to 90% of people once considered allergic are ultimately able to tolerate penicillins resulting in the decreased need for broad-spectrum antibiotics and development of multi-drug resistant organisms. All penicillins share the same core beta-lactam and thiazolidine ring structures but differ in their side chains. The penicillin family of antibiotics includes penicillin derivatives of ampicillin and amoxicillin as well as cephalosporins, monobactams, carbapenems, and beta-lactamase inhibitors. Penicillin is also one of the most frequently reported medication allergies. Today, penicillin is still one of the most widely prescribed antibiotics. Penicillin (PCN) was discovered by Alexander Flemming in 1928 and became widely used in 1942 to treat various staphylococcal and streptococcal bacterial infections.
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