Results of the National Institute of Allergy and Infectious Diseases Collaborative Clinical Trial to test the predictive value of skin testing with major and minor penicillin derivatives in hospitalized adults.

Background: A history (or lack thereof) of penicillin allergy is known to be unreliable in predicting reactions on subsequent administration of the drug. This study tests the usefulness of four penicillin allergen skin tests in the prediction of IgE-mediated reactions subsequent to administration of penicillin.

Methods: Eight centers cooperated in the National Institute of Allergy and Infectious Diseases trial of the predictive value of skin testing with major and minor penicillin derivatives.

Penicillin allergy.

Although many new antibiotics are available, penicillin and its many semisynthetic derivatives are first-line drugs for many infections. These agents are relatively nontoxic even at high doses; however, their use frequently leads to allergic reactions. Withholding penicillin therapy from patients at high risk of allergic reaction to it is the most effective means of preventing such occurrences.