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Month: May 2015

Do You Have a Penicillin Allergy?

Many people think that they are “allergic” to penicillin, when they may not really be truly allergic.

Penicillin is a very effective and relatively inexpensive antibiotic, used in the treatment of many bacterial infections.  About 1 in 10, 000 people who receive penicillin may have a true allergic reaction, where the immune system considers the antibiotic as a harmful foreign agent and mounts a defensive attack.  The chemical mediators that are released during this process can cause itchy rashes, hives, and/or swelling of the tissues.  In rare cases, life threatening reactions can occur in which difficulty in breathing (i.e., wheezing, shortness of breath), cardiovascular manifestations (i.e., drop in blood pressure, shock) and other serious organ system damage can ensue.

However, two recent studies proved that most people who consider themselves allergic to penicillin can safely receive penicillin.  In one study, 94 percent of 384 people who believed they were allergic to penicillin tested negative for penicillin allergy.  In the second study, penicillin skin testing was performed on 38 people who believed they were allergic to the antibiotic, and all of them tested negative.

Most people with a presumptive history of sensitivity to penicillin are given alternate antibiotics to treat infections.  In some instances, the replacement antibiotic may not be as effective as the preferred penicillin and in addition, the substitute antibiotic is also more expensive.  Such use may also result in some bacteria developing resistance to antibiotics, harming the community at large.  Hence it is important to distinguish between false and true allergy to penicillin and related antibiotics.

A standardized skin testing procedure can differentiate people who are likely to adversely react to penicillin from those who can safely tolerate it.  It involves injecting small amounts of chemical determinants (reagents) of penicillin sensitivity into the layers of the skin, with appropriate positive and negative controls.  A positive test manifests as an itchy, red, raised bump after 15 minutes and confirms true allergy to penicillin and the need to permanently avoid penicillin and related antibiotics.

If the skin test is negative, a related drug, amoxicillin is given by mouth at a standard dose and the person is monitored in a board certified allergist’s office for 1 to 2 hours for any adverse reactions.  If the oral dose is also tolerated, he/she can safely receive penicillin and related antibiotics to treat infections in the future.

The board certified allergists at Black & Kletz Allergy can administer the penicillin skin testing and oral challenge, if needed, and can offer recommendations for appropriate antibiotic use based on the test results.  Please call any of our 3 offices in the Washington, DC, Northern Virginia, and Maryland metropolitan area with questions or concerns related to antibiotic or other medication allergies.  We have office locations in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA and have been serving this area for more than 50 years.  There is parking at each one of our 3 office locations.  In addition, the Washington, DC and McLean, VA offices are also accessible by the Metro.  If you have wondered if your “penicillin allergy” was correct, please call us today or click Request an Appointment and we will contact you within 24 hours of the next business day.  We would be happy to test you for a penicillin allergy, so that you can clarify if you are truly allergic to penicillin.

Grass Pollen Allergies in the Washington, DC Metropolitan Area

In the Washington, DC, Northern Virginia, and Maryland metropolitan area (DMV area), grass begins to pollinate in late-April to early-May, peak in late-May or early-June, and end in August.  In addition to the grass pollen during this time period, molds spore counts are also highly elevated which further complicates one’s allergies.  There is also an overlapping with tree pollens in the early Spring, meaning that all three allergens (trees, grasses, and molds) are in the environment at the same time during some periods in the Spring.

The most common types of grasses include Timothy, Sweet vernal, Bermuda, Rye, Kentucky blue, Orchard, Meadow fescue, Red top, Bahia, and Johnson.  Grass pollens, unlike other environmental allergens, are very similar in their microscopic appearance.  This fact is the reason why an individual who is sensitized with one type of grass may have allergy and/or asthma symptoms when exposed to many other types of grasses.  The one major exception to this rule is Bermuda grass, which does not cross react with many other grasses.

As with the other allergens that cause hay fever (allergic rhinitis), allergic conjunctivitis, and/or asthma, it is the wind disbursement of the grass pollen into the air that sensitizes individuals.  Since the grass pollen is very light in weight, the wind causes the pollen to be carried in the air where people inhale the pollen and have direct contact with the pollen and their eyes.  It is this interaction that causes some people to develop allergies to the grass pollen which in turn causes the classic symptoms of hay fever, allergic conjunctivitis, and/or asthma. These symptoms may include some or all of the following:  sneezing, itchy nose, runny nose, nasal congestion, post-nasal drip, sore throat, hoarseness, itchy eyes, watery eyes, puffy eyes, sinus congestion, sinus pain, wheezing, coughing, shortness of breath, and/or fatigue.

Grasses tend to pollinate more the longer they grow.  Therefore, keeping one’s lawn mowed reduces the grass pollen that enters the air.  It is the tall grasses found in empty lots and by the sides of the roads, etc. that is the primary cause of the high grass pollen counts found in the Spring in the Washington, DC area.  Warm, windy, and dry days tend to increase the grass pollen counts.  The grass pollen counts also tend to be the highest in the early mornings.

There are preventive measures that should be practiced by all grass allergy sufferers and include the following:

  1. Although it is better to have the lawns mowed, the allergic individual should avoid mowing lawns. If he/she must mow the lawn, wearing a filtered mask may help reduce grass pollen exposure.
  2.  Turn air conditioning on.
  3.  Change air filters monthly.
  4. Keep sunroofs and windows closed.
  5. Shower, wash hair, and change clothing after coming back inside.
  6. Avoid yard work or wear a filtered mask.
  7. Wash pets after they go outdoors.
  8.  Re-circulate air in car so it doesn’t come in from the outside.
  9. Drive a car that has an air filter, if possible.

The board certified allergists at Black & Kletz Allergy have been diagnosing and treating grass pollen allergies in children and adults in the Washington, DC, Northern Virginia, and Maryland metropolitan area for more than half a century.  If you experience any of the above symptoms in the late Spring and Summer, you may suffer from grass allergies.  It is important for a board certified allergist to perform a detailed history and physical examination.  Allergy testing can be performed via the skin or blood to determine if one has an allergy to grass or other environmental allergen such as trees, molds, etc.  Treatment begins with prevention.  It may not be possible to completely avoid exposure to grass pollen, however, certain preventive measures can still help alleviate some of the suffering.  There a wide array of medications that can be tried which may include tablets, capsules, syrups, powders, nasal sprays, eye drops, and/or asthma inhalers.  Allergy immunotherapy (also referred to as allergy shots or allergy desensitization) is a very effective means to treat grass and other environmental allergies.  It is effective in about 80-85% of patients.  They have been around for over 100 years.  They can be given to almost anyone, including children and pregnant women.

If you would like to be seen at one of our 3 convenient locations in Washington, DC, McLean, VA (Tysons Corner, VA), or Manassas, VA, please call us to make an appointment.  Alternatively, you can click Request an Appointment and we will get back to you within 24 hours by the next business day.  We have parking at each office location and we are Metro accessible at our Washington, DC and McLean, VA locations.  Black & Kletz Allergy provides a friendly and caring environment for you to get the top quality allergy, asthma, and immunology treatment that we have been providing the community for more than 50 years and that you deserve.