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Re: The Infamous "Amoxil Rash"

I like to re-challenge all amox rashes twice. Occasionally get a repeat, but
rarely. I have never seen a life-threatening event following a second try of amox
in a child less than 10y. I hate to wall off such a great class of drug without
knowing for sure...
-gb
----- Original Message -----
From: "Michael Sachs" <>
To: <>
Sent: Sunday, February 17, 2002 5:12 PM
Subject: Re: The Infamous "Amoxil Rash"


>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