Current Knowledge and Management of Penicillin Allergy by Primary Care Physicians and Points for Improvement

Rationale: Penicillin allergy is commonly misdiagnosed, leading to a negative impact on patients` health. This study aimed to evaluate the knowledge and management of penicillin allergy by primary care physicians (PCP), to investigate if PCP are willing to perform penicillin allergy evaluation (PAE) and what will facilitate such an evaluation.

Methods: A cross-sectional study using a 22-question questionnaire that was emailed to family physicians and pediatricians. The questions focused on knowledge and management of penicillin allergy utilizing case-scenario and on the motivation of PCP to perform PAE.

Results: Out of 328 PCP, 169 pediatricians (55%) and 134 family physicians (45%) completed the questionnaire. Only 64% of family physicians, compared to 88% of pediatricians, believed that PAE is important. Seventy percent of PCP overestimate the duration of penicillin allergy and 30% overestimate its severity. While 90% of PCP correctly recognized anaphylactic reaction to penicillin, 60% failed to recognize severe delayed reactions (Such as Steven’s Johnson Syndrome) . Both groups stated that having the appropriate equipment and staff are the most important factors needed to perform PAE in the community. Giving appropriate resources, 62% of pediatricians and 42% of family physicians will perform PAE. Junior pediatricians (less than 10 years seniority) were more likely to perform PAE, compared to senior pediatricians (93% vs. 52%, P=0.03, respectively).

Conclusions: Additional education is required to PCP regarding the natural history of penicillin allergy and the management of severe delayed reactions. By providing appropriate resources, especially to junior pediatricians, a significant number of PCP are expected to perform PAE.