Antibiotic allergy testing was Re: sulfa drugs

[Guest guest]

Per my current allergist, testing for antibiotic allergies can't be

done at allergist's office right now, as they don't have anything

available from a manufacturer ( " out of the bottle " ). My tests were

done over 10 years ago, when they were available at my previous

allergist's office.

On the other hand, other medical centers or universities may have the

expertise to set up the tests themselves. The impression I get is

that the Mayo Clinic and others don't think the tests are valid

(except for penicillin *maybe*, which isn't available commercially

anyway, according to my allergist). Penicillin allergies are

considered to be IgE-mediated directly, but some other antibiotics

are thought to involve drug metabolites.

In my case, no one believed I had a penicillin allergy and the issue

was my career, as I had great job opportunities at the local

pharmaceutical company, but unfortunately they made most of the

world's penicillin at the facility, and even being exposed to it on

an interview (through the air) gave me a severe rash. The allergy

testing confirmed (in my mind) that the rash was most likely to that

brief and mild penicillin exposure, and I could never work there.

My major symptom when I last took penicillin was severe hives all

over my body - not a rash or GI problems. When I was exposed to it

in the air, I got mild case of hives all over (one single exposure of

a few hours, nowhere near a full course or even not a full dose).

I'm sure you've seen on this list that YMMV is the rule, and that's

certainly true with medical experts in some cases.

Take care,

RH

> Just to clarify, the part of my post that contained that statement,

about a

> test for sulfa allergy, was inside a word-for-word quote (that I

enclosed in

> quotation marks) from http://www.mayoclinic.com which I reproduce

again

> below. It was taken from a Mayo Clinic response to a forum

question. When I

> first read Ann-Marie's remark that I had posted that, I didn't even

believe

> it myself until I re-checked how and why I had done so. Anyway, I

suppose

> this is either an error on the part of Mayo Clinic (or perhaps pre-

dates the

> test?), or else there's some technical dispute over the EXACT

definition of

> " allergy " or " test " or " reliable " . I myself have NO expertise on the

> subject, other than the (non-quoted) part of my original post about

the

> chemistry of sulphur compounds. LONG ago I was a dedicated amateur

> high-school chemist, and then majored in chemistry at M.I.T.

>

> Steve D.

>

> THE SUSPECT QUOTE:

>

> " Sulfa isn't the same as sulfate. Sulfa is short for

sulfamethoxazole. Some

> people are allergic to sulfa antibiotics such as sulfamethoxazole,

which is

> found in the combination antibiotics Bactrim and Septra. Sulfate,

also

> spelled sulphate, is a chemical term that identifies specific salts

> containing sulfur. Sulfur is a mineral that's found naturally in

animal

> protein (including meat, poultry, fish and eggs), dried beans and

other

> vegetables. Sulfa antibiotics don't contain sulfates.

>

> For these reasons, people who are allergic to sulfa antibiotics

wouldn't be

> allergic to dietary supplements containing sulfates. The most common

> allergic reaction to sulfa drugs is a skin rash. There's no

reliable test

> for allergy to sulfa antibiotics. A doctor may make a diagnosis of

sulfa

> allergy based on the signs and symptoms. "

>

>

> > Date: Sun, 31 Jul 2005 20:57:16 -0000

> > From: " ohgminion "

> > Subject: Re: Sulfa drugs

> >

> > > Steve, funny that you mentioned that there is no real test to do

> > > for an allergy to sulfa drugs.

> >

> > I didn't notice that in his post, or I would have spoke up. Back

in

> > 1991, I was tested by an allergist for allergies to multiple

> > antibiotics, and was positive for penicillin, cephalosporin, and

> > sulfa drug allergies. The test for sulfa drug allergies used

> > Gantrisin. Because of the danger of even the skin test with a

1/1000

> > solution of each antibiotic, the doctor did the testing himself,

not

> > a nurse or tech.

> >

> > I know that as of a few months ago, my allergist said that the

> > preparation used to test patients for penicillin allergies is not

> > available (I didn't specifically ask her about sulfa drug testing

at

> > the time). She said hopefully it will be available in the future.

> > This is of concern to me because now my two-year-old got hives the

> > last time she had Amoxicillin, and they say if it is a true

allergy

> > (that is, if antibodies are building up to the drug in your

body), we

> > could die if we get exposed to penicillin again.

> >

> > The allergists are at the whims of consumer demand and the

> > manufacturers of the antibiotic skin test formulations, so perhaps

> > they don't make the proper Gantrisin formulation anymore.

> >

> > This is interesting - it lists drugs that *aren't* antibiotics but

> > *are* sulfa drugs (like Celebrex!):

> >

> >

http://www.intelihealth.com/IH/ihtIH/WSIHW000/7945/7991/370729.html

> >

> > Take care,

> > RH

> >

> > > When I mention my allergy to sulfa drugs to the

> > > doctors, nurses, etc...they never questioned my allergic

reaction

> > to the

> > > drug. I get the worse hives you can imagine, and I swell up and

my

> > whole

> > > body gets red. It drives me nuts. And I have noticed these side-

> > effects

> > > while I am on my TPN but not when I am off of my TPN. I receive

> > Amino Acids

> > > which is Protein in my TPN and those mentioned by to be

> > safe for

> > > sulfa allergies are not the ones listed in my particular

formula of

> > TPN.

> > >

> > > Anyways, thank you all for being so kind and helping me get to

the

> > bottom

> > > of this. I hate allergies and with Mito it is so much harder to

> > figure out.

> > >

> > > Have a great day

> > > Hugs,

> > > Ann-Marie

> > >