Table of ContentsView AllTable of ContentsSymptomsDiagnosisTreatmentsWhat You Should Know
Table of ContentsView All
View All
Table of Contents
Symptoms
Diagnosis
Treatments
What You Should Know
Verywell / JR Bee
Symptoms of a Penicillin Allergy
A penicillin allergy can cause life-threatening allergic reactions, but fortunately,most kids with a penicillin allergyhave more mild reactions, leading to simple skin rashes such as hives.
Children with more severe symptoms will experience hives as well aswheezing, difficulty breathing or swallowing, or swelling in their mouth or throat, as well as anaphylaxis—a serious allergic reaction.
How Anaphylaxis Is Treated
If your child just has hives (also called urticaria), you will likely notice red or pink raised areas on your child’s skin that are itchy, varied in size, and come and go over several hours.They often don’t go away completely, though. Instead, older hives go away in one part of your child’s body, while new ones continue to appear somewhere else. Any individual hive shouldn’t last more than 24 hours. If it does, then your child may have a similar skin rash, such aserythema multiforme, and not simple hives.
Is It a Penicillin Allergy?
Unfortunately, penicillin allergies can be harder to diagnose than most parents can imagine. A study in the journalPediatricsfound that children whose parents said they had penicillin allergy based on family history or what the researchers referred to as low-risk symptoms (rash, itching, vomiting, diarrhea, runny nose, and cough) did not have an allergy to penicillin.
There are also some drug reactions that can cause rashes that are not antibody-mediated. These cell-mediated, delayed hypersensitivity reactions often occur when the child is taking an antibiotic and also has a viral infection. This type of morbilliform drug rash may be itchy as is often described as “widespread pink-to-salmon-colored macules and papules that usually start on the head, neck, or upper trunk then spread symmetrically downward and become confluent.”
If your child is already allergic to several antibiotics or if you would like to confirm whether or not your child is really allergic to penicillin, a pediatric allergist might perform allergy skin testing to help with the diagnosis.
In addition to stopping the penicillin that might be triggering your child’s allergic reaction, your child will likely be treated with an antihistamine, such as Benadryl (diphenhydramine), to relieve symptoms of hives anditching.
More severe reactions may need to be treated with steroids and/orepinephrine injection.
What You Need to Know About Penicillin Allergies
Other things to know about penicillin allergies include that:
Most importantly, keep in mind that many parents think their children are allergic to penicillin when in fact they aren’t. A pediatric allergist can help to figure out if your child is really allergic to penicillin.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bhattacharya S.The facts about penicillin allergy: A review.J Adv Pharm Technol Res. 2010;1(1):11-7.Shin M, Lee S.Prevalence and causes of childhood urticaria.Allergy Asthma Immunol Res. 2017;9(3):189-190. doi:10.4168/aair.2017.9.3.189National Organization for Rare Disorders.Erythema multiforme.Vyles D, Adams J, Chiu A, Simpson P, Nimmer M, Brousseau DC.Allergy testing in children with low-risk penicillin allergy symptoms.Pediatrics. 2017;140(2). doi:10.1542/peds.2017-0471American College of Allergy, Asthma & Immunology.Hives (urticaria).American Academy of Allergy Asthma & Immunology.Penicillin allergy FAQ.Weisser C, Ben-shoshan M.Immediate and non-immediate allergic reactions to amoxicillin present a diagnostic dilemma: A case series.J Med Case Rep. 2016;10:10. doi:10.1186/s13256-016-0801-2Additional ReadingConsultation and referral guidelines citing the evidence: how the allergist-immunologist can help.J Allergy Clin Immunol. 2006;117(2 Suppl Consultation):S495-523. doi:10.1016/j.jaci.2005.10.047Apter AJ, Kinman JL, Bilker WB, et al.Is there cross-reactivity between penicillins and cephalosporins?.Am J Med. 2006;119(4):354.e11-9. doi:10.1016/j.amjmed.2005.10.052Kliegman RM, Behrman RE, Jenson HB et al.Nelson textbook of pediatrics e-book.Elsevier Health Sciences.O’Hollaren MT.A review of Middleton’s allergy: Principles and practice, 6th edition, with online updates.MedGenMed. 2005;7(4):1.Salkind AR, Cuddy PG, Foxworth JW.The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy.JAMA. 2001;285(19):2498-505. doi:10.1001/jama.285.19.2498Song JE, Sidbury R.An update on pediatric cutaneous drug eruptions.Clin Dermatol. 2014;32(4):516-23. doi:10.1016/j.clindermatol.2014.02.005
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bhattacharya S.The facts about penicillin allergy: A review.J Adv Pharm Technol Res. 2010;1(1):11-7.Shin M, Lee S.Prevalence and causes of childhood urticaria.Allergy Asthma Immunol Res. 2017;9(3):189-190. doi:10.4168/aair.2017.9.3.189National Organization for Rare Disorders.Erythema multiforme.Vyles D, Adams J, Chiu A, Simpson P, Nimmer M, Brousseau DC.Allergy testing in children with low-risk penicillin allergy symptoms.Pediatrics. 2017;140(2). doi:10.1542/peds.2017-0471American College of Allergy, Asthma & Immunology.Hives (urticaria).American Academy of Allergy Asthma & Immunology.Penicillin allergy FAQ.Weisser C, Ben-shoshan M.Immediate and non-immediate allergic reactions to amoxicillin present a diagnostic dilemma: A case series.J Med Case Rep. 2016;10:10. doi:10.1186/s13256-016-0801-2Additional ReadingConsultation and referral guidelines citing the evidence: how the allergist-immunologist can help.J Allergy Clin Immunol. 2006;117(2 Suppl Consultation):S495-523. doi:10.1016/j.jaci.2005.10.047Apter AJ, Kinman JL, Bilker WB, et al.Is there cross-reactivity between penicillins and cephalosporins?.Am J Med. 2006;119(4):354.e11-9. doi:10.1016/j.amjmed.2005.10.052Kliegman RM, Behrman RE, Jenson HB et al.Nelson textbook of pediatrics e-book.Elsevier Health Sciences.O’Hollaren MT.A review of Middleton’s allergy: Principles and practice, 6th edition, with online updates.MedGenMed. 2005;7(4):1.Salkind AR, Cuddy PG, Foxworth JW.The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy.JAMA. 2001;285(19):2498-505. doi:10.1001/jama.285.19.2498Song JE, Sidbury R.An update on pediatric cutaneous drug eruptions.Clin Dermatol. 2014;32(4):516-23. doi:10.1016/j.clindermatol.2014.02.005
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bhattacharya S.The facts about penicillin allergy: A review.J Adv Pharm Technol Res. 2010;1(1):11-7.Shin M, Lee S.Prevalence and causes of childhood urticaria.Allergy Asthma Immunol Res. 2017;9(3):189-190. doi:10.4168/aair.2017.9.3.189National Organization for Rare Disorders.Erythema multiforme.Vyles D, Adams J, Chiu A, Simpson P, Nimmer M, Brousseau DC.Allergy testing in children with low-risk penicillin allergy symptoms.Pediatrics. 2017;140(2). doi:10.1542/peds.2017-0471American College of Allergy, Asthma & Immunology.Hives (urticaria).American Academy of Allergy Asthma & Immunology.Penicillin allergy FAQ.Weisser C, Ben-shoshan M.Immediate and non-immediate allergic reactions to amoxicillin present a diagnostic dilemma: A case series.J Med Case Rep. 2016;10:10. doi:10.1186/s13256-016-0801-2
Bhattacharya S.The facts about penicillin allergy: A review.J Adv Pharm Technol Res. 2010;1(1):11-7.
Shin M, Lee S.Prevalence and causes of childhood urticaria.Allergy Asthma Immunol Res. 2017;9(3):189-190. doi:10.4168/aair.2017.9.3.189
National Organization for Rare Disorders.Erythema multiforme.
Vyles D, Adams J, Chiu A, Simpson P, Nimmer M, Brousseau DC.Allergy testing in children with low-risk penicillin allergy symptoms.Pediatrics. 2017;140(2). doi:10.1542/peds.2017-0471
American College of Allergy, Asthma & Immunology.Hives (urticaria).
American Academy of Allergy Asthma & Immunology.Penicillin allergy FAQ.
Weisser C, Ben-shoshan M.Immediate and non-immediate allergic reactions to amoxicillin present a diagnostic dilemma: A case series.J Med Case Rep. 2016;10:10. doi:10.1186/s13256-016-0801-2
Consultation and referral guidelines citing the evidence: how the allergist-immunologist can help.J Allergy Clin Immunol. 2006;117(2 Suppl Consultation):S495-523. doi:10.1016/j.jaci.2005.10.047Apter AJ, Kinman JL, Bilker WB, et al.Is there cross-reactivity between penicillins and cephalosporins?.Am J Med. 2006;119(4):354.e11-9. doi:10.1016/j.amjmed.2005.10.052Kliegman RM, Behrman RE, Jenson HB et al.Nelson textbook of pediatrics e-book.Elsevier Health Sciences.O’Hollaren MT.A review of Middleton’s allergy: Principles and practice, 6th edition, with online updates.MedGenMed. 2005;7(4):1.Salkind AR, Cuddy PG, Foxworth JW.The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy.JAMA. 2001;285(19):2498-505. doi:10.1001/jama.285.19.2498Song JE, Sidbury R.An update on pediatric cutaneous drug eruptions.Clin Dermatol. 2014;32(4):516-23. doi:10.1016/j.clindermatol.2014.02.005
Consultation and referral guidelines citing the evidence: how the allergist-immunologist can help.J Allergy Clin Immunol. 2006;117(2 Suppl Consultation):S495-523. doi:10.1016/j.jaci.2005.10.047
Apter AJ, Kinman JL, Bilker WB, et al.Is there cross-reactivity between penicillins and cephalosporins?.Am J Med. 2006;119(4):354.e11-9. doi:10.1016/j.amjmed.2005.10.052
Kliegman RM, Behrman RE, Jenson HB et al.Nelson textbook of pediatrics e-book.Elsevier Health Sciences.
O’Hollaren MT.A review of Middleton’s allergy: Principles and practice, 6th edition, with online updates.MedGenMed. 2005;7(4):1.
Salkind AR, Cuddy PG, Foxworth JW.The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy.JAMA. 2001;285(19):2498-505. doi:10.1001/jama.285.19.2498
Song JE, Sidbury R.An update on pediatric cutaneous drug eruptions.Clin Dermatol. 2014;32(4):516-23. doi:10.1016/j.clindermatol.2014.02.005
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