Multiple antibiotic allergies

January 14, 2003

I can understand your concern. Before penicillin was discovered, infections were a leading cause of death. I'll provide a more direct answer at the end of this item, but there are some things you need to consider first.

You should attempt to determine if you have a life-threatening allergy to these antibiotics. One doctor I worked for always wanted me to question patients about the type of reaction they had with each antibiotic they listed under "Medication Allergies."

Here are some typical responses:

"That one upset my stomach so bad I couldn't take it." This is not a symptom of a true antibiotic allergy. A side-effect of many antibiotics is nausea, vomiting, and diarrhea. This may be intolerable. But in the event you had a serious infection, you could still take the antibiotic along with medication to combat these stomach and intestinal side-effects.

"I felt like I was so tired I couldn't function." Infections often cause extreme fatigue. An infection may continue to get worse when an antibiotic is first started, until the antibiotic has a chance to "take hold." Likely your symptoms were caused by the worsening infection for which you were being treated.

"I had a rash. I was taking a new arthritis medicine, so I don't know if it was the antibiotic or the arthritis pill. The doctor told me to always list both as an allergy so I wouldn't be given them again."

This is a toss-up. Many people are allergic to non-steroidal anti-inflammatory medications which are commonly prescribed for arthritis. Also rashes can develop even if you are not taking medications. However, you should always tell your physician that you broke out in a rash when taking these meds. He probably won't give the antibiotic in question. But if he is concerned that you may need it later for a serious infection, he may recommend further testing by an allergist.

"My mom said I had a terrible reaction to that antibiotic. I was just a baby." You may have had any of the symptoms above: diarrhea; listless due to the infection; or a "rash" that could have been either a reaction to the antibiotic or just red flushed cheeks due to the fever and illness. Or you may have had a serious allergic reaction to the drug.

"I broke out in a rash and my throat swelled, I could hardly breathe."

The last reaction is very likely a true antibiotic allergy. However, studies have shown that people can outgrow a penicillin allergy. If your doctor feels you need to be able to take penicillin, she may refer you to an allergist for testing.

One study showed that over 80% of people who list penicillin as a drug allergy can actually take penicillin! Please do not just assume you are in that 80%. Never take an antibiotic that has not been prescribed for you and always let your physician know what type of reaction you had to penicillin. Discuss with her whether it may be safe for you to take penicillin.

Prevention is the best treatment for any allergy. Allergies to antibiotics are often brought on by overuse of them. Another complication from overuse of antibiotics is development of "super bugs" that develop resistance to antibiotics.

I've seen patients "nag" their physician to give them an antibiotic at the first sign of a sore throat or fever. Many viral infections mimic bacterial infections. Antibiotics can't help a viral infection. You may just have a simple cold, for which an antibiotic is worthless.

Your doctor may say, "Let's wait about the antibiotic. Call me Thursday if your symptoms are getting worse, and we will talk about whether you need an antibiotic."

God made our bodies in a marvellous way. Our immune systems are able to attack and destroy many intruding bacteria, thus preventing us from becoming deathly ill as we are exposed to these "bugs." When our bodies are unable to ward off the infection, most of us take the antibiotics prescribed with little thought of what a miracle drug they are.

Yet we sometimes expect too much. We want immediate relief, and are unwilling to give our own immune systems a chance to work before taking an antibiotic. Most viral infections will "run their course" in time, yet we beg our doctors for an antibiotic, rather than following his advice to "Call me Thursday...."

Multiple antibiotic allergies can be scary. If you are allergic to one antibiotic, you have 10 times the risk of an allergic reaction to another antibiotic, according to some sources.

Discuss this with your doctor. Keep track of the type of reactions you have to medications, especially antibiotics, and let your physician know. He can then determine if this is likely an intolerance or a true allergic reaction.

In life-threatening situations, antibiotics have been safely given to people who were allergic to them after pre-medicating with antihistamines, corticosteroids, and other medications.

Drug challenge testing can be done under a physician's supervision. In a drug challenge, a minute amount of the antibiotic is given and the amount is gradually increased. After a certain point is reached, if there is no reaction, it may be safely assumed that the patient can take the antibiotic. The physician must be present during the test to treat any life-threating reaction that might occur. Do not try this at home!

Never experiment with antibiotics on your own. Always talk with your physician about how best to deal with your health needs.

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