Allergic Reaction To Antibiotics


If you are allergic to antibiotics, you get signs and symptoms like a rash, swelling of the face or difficulty breathing.

A severe allergic reaction is known as anaphylaxis, and usually occurs within an hour of taking an antibiotic. A severe allergic reaction is a medical emergency requiring immediate medical attention. You may need to call triple zero (000) and perform first aid.

The symptoms of anaphylaxis are:

  • Difficult/noisy breathing
  • Swelling of the tongue
  • Swelling/tightness of the throat
  • Difficulty talking/hoarse voice
  • Wheezing or coughing
  • Dizziness or collapse
  • Pale and floppy (young children)

Sometimes you can get less dangerous symptoms before an anaphylaxis, such as:

The Australasian Society of Clinical Immunology and Allergy rrecommends that for a severe allergic reaction adrenaline is the initial treatment. If you are allergic to antibiotics you may be instructed by a doctor how to avoid triggers and if severe may instruct you how to use a self administered adrenalin injection such as epipen. The doctor will record the allergy and type of reaction in your notes and electronic health records and will give you an anaphylaxis action plan.

Most allergies are caused by penicillin or antibiotics closely related to penicillin, or by another type of antibiotic called sulfonamides. Feeling nauseous and vomiting after taking antibiotics is usually a side-effect of the medicine, rather than an allergic reaction. Your doctor can usually diagnose allergic reactions to antibiotics by talking to you. He or she may refer you to an allergy specialist, who may ask for skin allergy and blood tests. If you have any other concerns about antibiotics, including possible side effects, contact your doctor. Nowadays, several thousands of medications for different diseases treatment are used worldwide. Despite proven efficiency and safety of these drugs, they can cause some unusual reactions.

Thus, 15% of all side effects of drug therapy are allergic reactions.

Several types of drugs provoke allergic reactions more than any other drugs do, these are:

  • Antibiotic substances (up to 55%)
  • Nonsteroidal anti-inflammatory drugs (up to 25%)
  • Sulfanilamides (up to 10%)
  • Vaccines, vitamins, enzymes (up to 10%)

Allergic reaction to antibiotics is a natural reaction of the body to medication or its metabolites. The severity and frequency of allergic reaction depend on dosage of antibiotics and time people use them.

Usually, a single or preventive application of antibiotics does not cause side effects. A long-term parenteral use of high doses of antibiotics (like injections) increases the risk of allergic reaction.

The majority of allergic reactions to antibiotics have similar signs:

  • Occur in small number of people
  • Develop quickly in repeated administration of an allergen
  • Appear when using antibiotics with identical chemical structure

If a patient has allergic reaction to antibiotics, he should stop using the drug and determine the cause of this reaction. Hypersensitivity to antibiotics occurs either on the active pharmaceutical ingredient, or on excipients. If allergic reaction is caused by the active substance, then you need to use other antibiotic.

If doctor finds out that allergic reaction was caused by excipients, then you can buy and use some similar antibiotic drug by other pharmaceutical company. Typically, antibiotics manufacturers use different excipients. You can find the list of excipients in the leaflet.

It should be noted that frequent repeated antibiotic therapies increase the risk of side effects and allergic reactions. If you are sensitive to various allergens, you can buy antibiotics for a short-term therapy. Such medications rarely cause side effects.

Distributors of antibiotics supply same medications in different pharmaceutical forms. The safest pharmaceutical forms of antibiotics are tablets or capsules. Local application or parenteral route of administration of antibiotics increases the risk of adverse reactions.

There are risk factors of allergic reactions that do not depend on the type of used antibiotics. These factors are age, sex and constitution peculiarities (for instance, leanness). It must be said that drug allergy is milder and less harmful in elderly and children.

Antibiotics effects may vary from mild allergic reactions to severe and exhausting side effects. Treatment of allergic reaction to antibiotics should be started when the first signs and symptoms occur.

Hypersensitivity to antibiotics, as well as allergy to other medications can be determined according to Gell and Coombs classification. In some cases, symptoms of allergy may be dangerous for health.

The most common allergic reaction to antibiotics is usually one of the listed below:

  • Rash, irritated skin, blisters
  • Anaphylactic shock
  • Drug fever
  • Low blood pressure
  • Edema and narrowing of the larynx

As well as other medications, antibiotics are not recommended for use during pregnancy. Except for the cases when it is a necessity. Allergic reaction to antibiotics during pregnancy is mostly the same in women, who are pregnant and who are not, yet it can be stronger.

One of the most common causes of antibiotic intolerance is considered penicillin. Antibiotics of this type require a special attention because of their popularity. In fact, penicillin causes side effects and leads to hospitalization more often than any other antibiotic drugs.

If you use antibiotics from time to time and you are allergic to penicillin, you must be aware what drugs you can take. Obviously, you should not buy antibiotics which name contains ‘Penicillin’ word.

At the USA pharmacies, you can buy several antibiotics which name has ‘Penicillin’ in it – Penicillin-Vk, Penicillin G Potassium, Penicillin G Sodium and others. The UK pharmacies offer to buy Penicillin-Vk (tablets and capsules) and Phenoxymethylpenicillin (granules for oral solution).

Antibiotics containing active substance Penicillin are also available under brand names containing no word ‘Penicillin’ (for example, Amoxicillin, Cilicaine Syringe, Bicillin, Penapar and V-Cillin). You may find the information on substances of the drugs in the leaflet.

Allergic reaction to antibiotics often occurs if drugs are used improperly. To maximally reduce the risk of adverse reactions,

you should follow some simple recommendations:

  • If you have no idea what infection a particular antibiotic is meant for, do not use it
  • Learn side effects of antibiotics and take precautions
  • Use antibiotics in recommended doses only (no less, no more)
  • Continue using antibiotics until you are completely healthy

If antibiotics pills cause allergy – skin rash, itching, difficult breathing or another serious reaction, a person should stop using it and never take it again. Use antibiotics only when strictly necessary.

What is an antibiotic medication allergy?

An antibiotic medication allergy is a harmful reaction to an antibiotic. The reaction can start soon after you take the medicine, or days or weeks after you stop. Healthcare providers cannot know ahead of time if you will have an allergic reaction. Your immune system may become sensitive to the antibiotic the first time you take it. You may have an allergic reaction the next time. The antibiotics most likely to cause an allergic reaction are penicillins and cephalosporins.

What are the signs and symptoms of an allergic reaction to an antibiotic?

  • Mild symptoms include red, itchy, flaky, or swollen skin. You may have a flat, red area on your skin that is covered with small bumps. You may also have hives.
  • Severe symptoms include skin that blisters or peels, vision problems, and severe swelling or itching. Severe reactions include conditions such as toxic epidermal necrolysis (TEN). Ask your healthcare provider for more information on TEN and other serious conditions.
  • Anaphylaxis symptoms include throat tightness, trouble breathing, tingling, dizziness, and wheezing. Anaphylaxis is a sudden, life-threatening reaction that needs immediate treatment. Anaphylaxis may occur if you exercise after exposure to a trigger, such as after you take an antibiotic.

What increases my risk for an antibiotic medication allergy?

  • Other allergies, such as to cats
  • A family history of antibiotic allergies
  • Frequent use of antibiotics
  • A long-term illness that makes your immune system more sensitive

 How is an antibiotic medication allergy diagnosed?

Your healthcare provider will ask about your medical history and allergies. You may need additional testing if you developed anaphylaxis after you were exposed to a trigger and then exercised. This is called exercise-induced anaphylaxis. You may also need any of the following:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  • A patch test means a small amount of the antibiotic is put on your skin. The area is covered with a patch that stays on for 2 days. Then your healthcare provider will check your skin for a reaction.
  • A skin prick test means a small drop of the antibiotic is put on your forearm and your skin is pricked with a needle. Your healthcare provider will watch for a reaction.
  • An intradermal test means a small amount of antibiotic liquid is put under the surface of your skin. Your healthcare provider will watch for a reaction.
  • A drug provocation test is also known as an antibiotic challenge test. Your healthcare provider gives you increasing doses of the antibiotic medicine and watches for a reaction.
 How is an allergic reaction to an antibiotic treated?
  • Antihistamines decrease mild symptoms such as itching or a rash.
  • Epinephrine is medicine used to treat severe allergic reactions such as anaphylaxis.
  • Steroids reduce inflammation.
  • Desensitization may be done after you have a reaction, if you need to be treated with the antibiotic again. Your healthcare provider will give you small doses of the antibiotic over a few hours. He will treat any allergic reaction that you have. The dose is increased a little at a time until the full dose is reached and the medicine stops causing an allergic reaction. You will have to take a dose of the antibiotic every day to keep your body desensitized.

What steps do I need to take for signs or symptoms of anaphylaxis?

  • Immediately give 1 shot of epinephrine only into the outer thigh muscle.
  • Leave the shot in place as directed. Your healthcare provider may recommend you leave it in place for up to 10 seconds before you remove it. This helps make sure all of the epinephrine is delivered.
  • Call 911 and go to the emergency department, even if the shot improved symptoms. Do not drive yourself. Bring the used epinephrine shot with you.

What safety precautions do I need to take if I am at risk for anaphylaxis?

  • Keep 2 shots of epinephrine with you at all times. You may need a second shot, because epinephrine only works for about 20 minutes and symptoms may return. Your healthcare provider can show you and family members how to give the shot. Check the expiration date every month and replace it before it expires.
  • Create an action plan. Your healthcare provider can help you create a written plan that explains the allergy and an emergency plan to treat a reaction. The plan explains when to give a second epinephrine shot if symptoms return or do not improve after the first. Give copies of the action plan and emergency instructions to family members, work and school staff, and daycare providers. Show them how to give a shot of epinephrine.
  • Be careful when you exercise. If you have had exercise-induced anaphylaxis, do not exercise right after you eat. Stop exercising right away if you start to develop any signs or symptoms of anaphylaxis. You may first feel tired, warm, or have itchy skin. Hives, swelling, and severe breathing problems may develop if you continue to exercise.
  • Carry medical alert identification. Wear medical alert jewelry or carry a card that says you have an antibiotic medicine allergy. Healthcare providers need to know that they should not give you this antibiotic. Ask your healthcare provider where to get these items.
  • Read medicine labels before you use any medicine. Do not take the medicine if it contains the antibiotic that you are allergic to. This includes topical medicines that you put on your skin. Ask a pharmacist if you are not sure.
  • Tell all healthcare providers about your allergy. Always tell your healthcare providers the names of medicines that you are allergic to and the symptoms of your allergic reactions.
  • Ask if you need to avoid other medicines. You may be allergic to other medicines if you had an allergic reaction to an antibiotic. Make sure you know the names of other medicines that you should not take.

When should I seek immediate care?

  • You have a rash with itchy, swollen, red spots.
  • You have blisters, or your skin is peeling.
  • You have trouble swallowing or your voice sounds hoarse.
  • You have a fast or pounding heartbeat.
  • Your skin or the whites of your eyes turn yellow.

When should I contact my healthcare provider?

  • You think you are having an allergic reaction. Contact your healthcare provider before you take another dose of your antibiotic.
  • You have a rash.
  • You have a fever.
  • You have a sore throat or swollen glands. You will feel hard lumps when you touch your throat if your glands are swollen.
  • Your skin itches and becomes red when you are in sunlight.
  • You have questions or concerns about your condition, allergy, or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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