Penicillin Allergy Testing safe?

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MKW
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Penicillin Allergy Testing safe?

Postby MKW » Sun Oct 01, 2017 8:17 pm

This will possibly sound like a paranoid question, but I fully admit to my PTSD and obsessive fear of C Diff post recovery!, so here goes...
I had C Diff 4 times, and ended up with a successful first time FMT in March 2017. I have been OK since except some IBS.
I developed it after I was prescribed Clindamycin for a gum infection by my dentist because I can't take Penicillin antibiotics because I am "supposedly" Penicillin allergic.
So, Clindamycin is the drug dentists seem to always prescribe as the alternative in Penicillin allergic patients.
When I was 11 years old I went through allergy testing due to seasonal allergies to trees/grass/etc, and the doctor did a penicillin test. He said based on the size of my reaction to the skin test I was allergic. I had taken Penicillin/Ampicillin throughout my entire childhood multiple times with no reaction. However, from that point forward my parents and then me in adulthood have told all doctors and dentists I am allergic.
I have read recently that even for people who have had a Penicillin reaction, that after 10 years they may be OK to take it.
I NEED to know if that family of antibiotics is an option for me since I am at risk for C Diff. I have lots of dental problems, have had 2 root canals, 5 crowns, etc, and am only 46. My greatest fear is needing an antibiotic for a dental problem, not other medical problem.

So, my question is - will a Penicillin skin test by an allergist expose me to enough antibiotic to damage my gut flora or risk C Diff recurrence?

I am assuming some is injected transdermally to do the skin test. But don't know much more than that. I know you guys don't give direct medical advice, but does anyone know anything about this or has anyone ever heard if this could be a risk for someone with my C Diff history? My PCP has told me I SHOULD do the test, and the nurse at my GI doc's office said I should go with the assumption I am allergic and didn't know if it would be risk for me or not. Thanks! - Melanie

NanciT
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Re: Penicillin Allergy Testing safe?

Postby NanciT » Sun Oct 01, 2017 9:45 pm

I understand your concern and want to mention I too have had dental issues POST CDIFF. In fact, my dentist has been shocked by how many issues have come up. I have the perodex rinse on hand and have used it on and off during all of the dental issues. I have NOT taken any antibiotics for any of the dental issues. There are cases where they might be necessary, but Post CDIFF my dentist understands and we try everything else first. That also includes the Periodontist and Oral surgeon I have seen.

If you have a history of a PCN allergy and have concerns, see an allergist and explain your concerns. Once someone has actually tested positive, I am not aware they test again but seeing an allergist is your best bet.

NanciT

ResearchGrandma
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Re: Penicillin Allergy Testing safe?

Postby ResearchGrandma » Sun Oct 01, 2017 10:28 pm

I had penicillin skin allergy testing prior to C. diff. It is not really a deep injection - more like a pinprick/scratching of the skin. I tested negative by the skin test, but when I tried taking amoxicillin - I had the same late onset reaction that I had experienced 25 years earlier. After 6-7 days I developed a measles like itchy rash that took 6 weeks to clear up.
So no penicillin/ amoxicillin for me. After C. diff I did an oral challenge of one dose of cephalosporin in an allergist's office. It slightly upset my GI system for a week or two, then I recovered. I am not a doctor but I think the amount of penicillin used for skin testing is much less than one dose and does not really get very far into the body.
I had an infected dental cyst from a cracked root about 18 months ago, and needed treatment and dental surgery (pulling the tooth and scraping out the infected bone, adding bone graft). I checked with my GI doctor and ended up taking a course of doxycycline and then one of flagyl (but it was a lower dose than used for treating C. diff) . My GI system got upset by the doxycycline but the (awful to take) flagyl calmed it. Almost a year ago I had a dental implant. The oral surgeon usually prescribed 2 doses of either penicillin or clindamycin before the procedure, but was willing to do it without any preoperative antibiotics. But since the rate of implant failure/infection is definitely higher without antibiotics, I wanted to take something - he researched and suggested levaquin (one dose). I checked with my infectious disease doctor - she didn't think the one dose would be a problem. I found the implant area difficult to keep clean while the implant area was healing, cap was on, but not covered by a crown. Ultimately what worked was rubbing the gum area with Peridex using a cotton-tipped applicator.

georgina
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Re: Penicillin Allergy Testing safe?

Postby georgina » Mon Oct 02, 2017 12:45 am

The injection is in the skin and the quantity of antibiotic is very small, less them 1 ml and is also diluted ,so I do not think that there a risk of being exposed to Cdiff from it.

roy
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Re: Penicillin Allergy Testing safe?

Postby roy » Mon Oct 02, 2017 2:55 am

My biggest concern is that you were routinely prescribed antibiotics for root canals and crowns!
Dentists need educating on the correct use of antibiotics.

I would think the skin allergy test is not a problem and its a very good idea to check if low offenders are an option, but even low offenders should not be used for minor irritations that will clear up on their own.
I had allergy tests many years ago, (I suffered badly with alergys then) lots of the areas were inflamed by the pin pricks and I was given a list of things I was alergic to and when to take antihistamins.
Over the years the allergys stopped and now I am no longer allergic to ANY of the things I was tested for!

MKW
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Re: Penicillin Allergy Testing safe?

Postby MKW » Mon Oct 02, 2017 10:29 pm

Thank you so much for all the feedback, and especially accounts of your personal experiences. This is a big help to me!
I plan to schedule an appointment with an allergist soon to get this figured out. But with my luck, like most medical professionals I have dealt with since C Diff, they will have little to no knowledge of C Diff or experience in dealing with someone like me. This is why everyone's input on here is so helpful.
After what I have been through and reading of so many other's cases of C Diff from Clindamycin from dentists, it seems that dentists in general are just behind in the current effort in the medical community to avoid antibiotics and especially broad spectrum antibiotics if at all possible.


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