We noticed a seemingly high prevalence of
penicillin allergy in patients who had been diagnosed with
peritonsillar abscess (PTA) at our institution. To formally investigate this observation, we reviewed the emergency room (ER) records of 118 patients who had presented between Jan. 1, 1995, and Dec. 31, 1999, with suspected PTA. A diagnosis of PTA was confirmed by the presence of
pus on incision and drainage in 78 of these patients (66.1%). The remaining 40 patients (33.9%) were diagnosed with peritonsillar
cellulitis (PTC). Of the 78 patients with confirmed PTA, 13 (16.7%) self-reported an
allergy to an
antibiotic, including 11 (14.1%) who claimed to be allergic to
penicillin. In the 40 patients with PTC, the corresponding figures were only 3 (7.5%) and 1 (2.5%). The difference between the PTA and PTC groups with respect to the prevalence of self-reported
penicillin allergy was statistically significant (p < 0.05). We also compared the prevalence of
antibiotic allergies in our patients with that of 1,893 consecutively presenting patients whose records had been entered into a pharmacy database at our institution. We found that the overall prevalence of patient-reported
penicillin allergy in our PTA group was similar to that of the database population, although
penicillin allergy did account for a greater percentage of all
antibiotic allergies (84.6%) in our PTA group than in the larger population (62.8%). In our series, patients with PTA were more likely to have reported an
allergy to
penicillin than were patients without an
abscess. Additionally, the prevalence of patient-reported
antibiotic allergy is high at our institution. Although self-reported
penicillin allergy may not represent a true
hypersensitivity reaction, it can influence
antibiotic selection and/or compliance. Prospective studies are needed to determine what influence allergic status and
antibiotic choice has on
abscess development.