New patients coming to the PATS outpatient clinic will have penicillin testing done that same day in most cases. Patients take a dose of amoxicillin (the most commonly prescribed form of penicillin) at the beginning of the appointment, and our allergy staff observe them for an hour to make sure that there is no reaction. Rarely, staff may perform a skin test prior to administration of amoxicillin. After testing, PATS offers numerous supports, including access to allergy providers if you are concerned about allergic symptoms or have additional questions after the visit. Allergic symptoms during or after the challenge are uncommon (5% of children) and very mild.
Children labeled with penicillin allergy who are admitted to the Hospital Medicine Service will be offered the opportunity for allergy testing through PATS. If a patient is not on the preferred antibiotic for their infection because of a penicillin allergy, the patient may be evaluated and tested while the child is in the hospital. Testing will be offered Monday through Friday. Patients may also be referred for testing as an outpatient if the timing for amoxicillin challenge in the hospital is not ideal.
Office Visits for Children Currently Experiencing Allergy Symptoms
Additional opportunities for the same or next day visits are provided for patients who are currently experiencing a reaction while taking an antibiotic. Many of these children go to the emergency room to be seen, with up to 40% of infants returning for a second visit within 24 hours if their condition has not improved. These children may now be seen at the PATS outpatient clinic either in person or by telemedicine.
Dr. Risma says, "Every day, patients come to the emergency room who are being treated with amoxicillin and have a rash like hives and perhaps lip or eye swelling. In the winter, it may be 2 or 3 patients a day, and they often return the next day with more concerns. We intentionally hold appointment spots open for patients who have an urgent need to be seen. Usually, caregivers simply need a clear plan for symptom relief, reassurance with the appearance of new symptoms, and information on how long the condition will last."
Learn more about serum sickness-like reactions (SSLR), in which the body’s immune system mistakenly identifies a substance (commonly an injectable medicine) as harmful.