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I saw the allergist this morning. He asked me a bunch of questions, including wanting me to describe the rash and about medications other than the antibiotics I was wondering about, and decided it did make sense to test for an allergy to penicillin.
So he took the residents* off into another room, where he either showed them diluting the penicillin or had one of them do it. Then I got pricked (they say "scratched") five times, and sent to wait for 20 minutes with my book. No reaction to anything except the histamine control. This is good, this what we want.
To confirm, he then gave me 2 amoxicillin capsules, totaling 500 mg, and had me sit in the waiting room a while longer. I had no obvious reaction, and he also looked at the areas where I had broken out last winter, i.e., chest, neck, and calves.
So I am not allergic to penicillin or amoxicillin, and can safely be given that family of antibiotics. However, as my GP warned me, there is no test for Bactrim allergy. There is also no test for a cephalosporin allergy as such. So:
I am to avoid Bactrim. If possible, avoid cephalosporins, and if a doctor thinks I need one, contact the allergist. Ditto for sulfa drugs other than Bactrim. In either case, he would probably want me to come in, and take the first dose in his office just in case. Sulfanilamides are a large family, including a number of things other than antibiotics, and some of those are more likely to cross-react than others. (One of the residents mentioned Lasix as one that would probably be okay, if I ever need it.) Taking the first dose in his office would be a precaution against anaphylactic shock, the thing allergists worry about most. It wouldn't do anything for the rash a month after taking the drug, or even a week into a ten-day course of medication.
The above is more or less what I was hoping for: the best outcome given the previous reactions and the current state of medical testing. I also verified that tetracycline is not a sulfa drug, so I can still use that. Just curious.
*I assume they were residents, because they were fairly young, and his office is in a teaching hospital. Not med students, because he introduced each of them as Dr. $name, not Ms. $name.
So he took the residents* off into another room, where he either showed them diluting the penicillin or had one of them do it. Then I got pricked (they say "scratched") five times, and sent to wait for 20 minutes with my book. No reaction to anything except the histamine control. This is good, this what we want.
To confirm, he then gave me 2 amoxicillin capsules, totaling 500 mg, and had me sit in the waiting room a while longer. I had no obvious reaction, and he also looked at the areas where I had broken out last winter, i.e., chest, neck, and calves.
So I am not allergic to penicillin or amoxicillin, and can safely be given that family of antibiotics. However, as my GP warned me, there is no test for Bactrim allergy. There is also no test for a cephalosporin allergy as such. So:
I am to avoid Bactrim. If possible, avoid cephalosporins, and if a doctor thinks I need one, contact the allergist. Ditto for sulfa drugs other than Bactrim. In either case, he would probably want me to come in, and take the first dose in his office just in case. Sulfanilamides are a large family, including a number of things other than antibiotics, and some of those are more likely to cross-react than others. (One of the residents mentioned Lasix as one that would probably be okay, if I ever need it.) Taking the first dose in his office would be a precaution against anaphylactic shock, the thing allergists worry about most. It wouldn't do anything for the rash a month after taking the drug, or even a week into a ten-day course of medication.
The above is more or less what I was hoping for: the best outcome given the previous reactions and the current state of medical testing. I also verified that tetracycline is not a sulfa drug, so I can still use that. Just curious.
*I assume they were residents, because they were fairly young, and his office is in a teaching hospital. Not med students, because he introduced each of them as Dr. $name, not Ms. $name.
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