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Re: The Infamous "Amoxil Rash"

I swear I thought it was Contemporary Peds but just searched the CP archives and couldn't find the article...

Eve H. Switzer, MD
rural peds

On Sun, 17 February 2002, "David Arkin" wrote:

>
> In the particular situation Michael quotes, with a non-urticarial
> exanthematous rash associated with Amoxil, I have been telling parents for
> years that this is an adverse reaction to Amoxil, but not an allergic
> reaction.  When the rash appears while the child is still taking the
> medicine, I tell the parent to complete the Amoxil course, since the rash
> will go away in 3 or 4 days whether the medicine is continued or not.  For
> subsequent illnesses, I prescribe penicillins as if no reaction had
> occurred.  In the dim dark recesses of my knowledge, I remember reading that
> this rash is not IgE-mediated, so there should be no additional risk of
> subsequent anaphylaxis, but I cannot give you the reference.  (Pediatrics in
> Review comes to mind, though).
> So far, no problems with this advice.
> David Arkin, MD
> Richmond, VA
>
>
> >From: Michael Sachs <>
> >Reply-To: Michael Sachs <>
> >To: 
> >Subject: Re: The Infamous "Amoxil Rash"
> >Date: Sun, 17 Feb 2002 14:12:37 -0800
> >
> >>In a message dated 2/14/2002 1:40:45 PM Eastern Standard Time,
> >> writes:
> >>
> >>
> >> > Anyone have any information on the infamous "Amoxil (amoxicillin)
> >>rash"?
> >
> >
> >
> >>At 04:31 PM 2/17/02 -0500,  wrote:
> >>No data, but I certainly see it.  That's why I ask lots of questions when
> >>parents tell me their child is allergic to something.  You really have to
> >>find out what kind of reaction they had.  Many tell me they vomited, or
> >>had
> >>some diarrhea, or something else like that.  Rashes are tougher, because
> >>they
> >>don't always remember what it looked like or whether it itched.  If I'm
> >>not
> >>really sure, I let them know that testing is available for penicillin
> >>allergy.
> >>
> >>Moshe Adler, MD
> >
> >
> >I seem to recall reading somewhere that 70-80% of people who report a
> >penicillin allergy actually are not allergic.
> >
> >Sometimes when I'm pretty confident that a non-urticarial rash is likely
> >one of these idiosyncratic Amoxil rashes or maybe a non-specific viral
> >exanthem I'll try Amoxil again at some point in the future.  I've rarely
> >seen the rash duplicated on a subsequent course of Amoxil.
> >
> >So here's a question back to the list:  If a child has had a non-severe,
> >non-specific, non-systemic, non-urticarial rash associated with Amoxil in
> >the past, is there likely to be a significant risk of anaphylaxis with
> >trying another course before doing formal skin or RAST testing?  Any
> >opinions?
> >
> >
> >
> >Michael Sachs, M.D.
> >General Pediatrician
> >
> >
>
>
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