Proactive testing for allergy to a medicine as a baby?

justdoit19

Proud parent of an ANG, USNA X2, and a MidSib
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DS #2 may decide to apply to service academies/ROTC, he is entering Junior year. A question: being through it all with DS #1, a '22 appointee, I am wondering if it makes sense to try and remedy a diagnosis that we had with him as an infant. An 'allergy' or 'reaction' to amoxicillin. At the time, he had a reaction to both amoxicillin and zithromax, but has since had zithromax and not reacted. So im wondering if that will also be an issue.

Any advice? Im trying to be proactive. I also don't know actually HOW to remedy, other than waiting for him to get sick and requesting DR to prescribe Amox? DS is healthy as a horse, hasn't had an antibiotic for a years....

Ideas? Advice?
 
My son also had a reaction to penicillin as a 2-year old. Before he went through DoDMERB last year I had his allergist do an oral challenge and he passed it. Some large percentage of the population (90% or so) are not actually allergic even though they may have reacted to it as a child. He disclosed previous reaction on DoDMERB exam, but then provided documentation regarding oral challenge results and it never came up again.
 
Wait until they ask for information.
Then only provide the information requested.
Being "pro-active" can expose more problems that otherwise might have been overlooked.
I don't think you can correct a diagnosis as they are primarily interested in "a history of".
When and if a DQ comes, the assigned DoDMERB is an excellent resource. If extra information exists that could help they can help evaluate its value.
 
I guess my point is they will ask for the information in the questionnaire. As soon as you say he has a history of reaction to a drug it will trigger a remedial, etc. If it can be cleared up prior then it makes sense to do it. If he doesn’t pass a challenge then the facts are the facts and they will make a separate decision based on that.
 
The majority of children who have an allergic reaction to an antibiotic will outgrow it. I always recommend that the children I see in clinic see an allergist to confirm or rule out the allergy. Even if your child does not attend a SA, I would see an allergist.
 
I don't even think reaction to penicillin requires a remedial or is a disqualifying condition - maybe because there are so many reasonable substitutes for that drug now?
 
I've had Sailors and Marines with three of the major antibiotic classifications listed as allergies in their health record. I ask them about the type of reaction they had when taking it and most of the answers were to the effect of, "my mom told me I was allergic to it." I agree with the above that allergy testing should be done. If a true allergy exists, as brob mentioned, acceptable alternatives are available.
 
We had two with allergies to penicillin go to USNA. Neither was required to submit a remedial.
 
DS #2 may decide to apply to service academies/ROTC, he is entering Junior year. A question: being through it all with DS #1, a '22 appointee, I am wondering if it makes sense to try and remedy a diagnosis that we had with him as an infant. An 'allergy' or 'reaction' to amoxicillin. At the time, he had a reaction to both amoxicillin and zithromax, but has since had zithromax and not reacted. So im wondering if that will also be an issue.

Any advice? Im trying to be proactive. I also don't know actually HOW to remedy, other than waiting for him to get sick and requesting DR to prescribe Amox? DS is healthy as a horse, hasn't had an antibiotic for a years....

Ideas? Advice?
Our DS2 had rashes when he took amoxicillin as a child. Throughout his childhood and through his time in Boy Scout we always put that down as his allergy. The year before he applied to USNA we had him do a full panel of allergy test on his back to see if he was still allergic to it and to find out if he is allergic to anything. The goal was to be proactive and also to know if anything he needs to avoid in life. He had no reactions to all of them. From that point on and including DODMERB paperwork he put down no allergies. No issues whatsoever. I strongly recommend you do the same.
 
Our DS2 had rashes when he took amoxicillin as a child. Throughout his childhood and through his time in Boy Scout we always put that down as his allergy. The year before he applied to USNA we had him do a full panel of allergy test on his back to see if he was still allergic to it and to find out if he is allergic to anything. The goal was to be proactive and also to know if anything he needs to avoid in life. He had no reactions to all of them. From that point on and including DODMERB paperwork he put down no allergies. No issues whatsoever. I strongly recommend you do the same.

To further understand, once the actual allergy test was performed and no allergy noted, he did not record any history of allergy/reaction even as a baby?

You situation is exactly ds’s. He has recorded an allergy to amox throughout. Although he did stop recording Zithromax as he has had that and not had a reaction. So I suppose it’s the same line of thinking: he never actually did have an actual allergy, which would be the same result from an allergy panel (assuming he isn’t actually allergic).

At this point I am leaning towards pursuing this option. I have always wondered if he actually DOES have this as a true allergy.

Any advise about this? Just go to any allergist? Any cautions about how or who to peruse this with?

I’m also aware this could be the proverbial can of worms. That is my hesitation [emoji849]
 
To further understand, once the actual allergy test was performed and no allergy noted, he did not record any history of allergy/reaction even as a baby?
Correct. We always thought the rash could be coincidental at the time, but all those years we did not feel the need to worry about it. We request the specialist through his primary doctor - I told her we would like to confirm he truly does have an allergy to Amoxicillin. Once the results were in, his doctor even change her note to “no allergies” on his file.

We also want to take the opportunity to find out if he has any allergy that we don’t know about. SA application/DODMERB implication asides, I thought knowing what he needs to look out for is way more important for the rest of his life.

We did not have to pay for the test. It was covered.
 
Developing hives, urticaria, closing airway, etc. after taking amoxicillin or any other 'cillin is possibly an allergic reaction. A light red rash is common with some people with some medicines. Simple rashes are not allergic reactions. As Zeus said, knowing what allergies our kids have is more important than anything else. I wouldn't put down an allergy though unless I really had one.
 
Another side effect of many antibiotics is sun sensitivity. If you are taking certain antibiotics, then are in the sun even for an hour or less, you can develop a red rash on the areas exposed. I have experienced this first hand many years ago when the doctor/pharmacist did not warn me, nor was it on the prescription.

Penicillin allergies are common, some are mild, some can be deadly. After a very severe reaction to penicillin when I was a small child, the doctor told my parents that if I was ever given penicillin again, it would kill me (I have a large scar from that episode). Later in life, both of my parents reacted to penicillin. I have never allowed doctors to prescribe penicillin to either of my DDs due to this family history.

A penicillin allergy is not a disqualifying condition for the SAs. As mentioned above, there are so many other antibiotics available.
 
Any advise about this? Just go to any allergist? Any cautions about how or who to peruse this with?
I would look for an allergist with a military background. Our allergist is retired Air Force, and he was VERY helpful answering the DoDMERB allergy questions
 
Your DS may have never been diagnosed with an allergy if it was a one time incident. Most of the physicians around my area will not diagnose an allergy. They leave that to the specialist. They will, however, not any reactions to a medication if they required intervention. It could be that you were functioning with an understanding of an allergy but there were never an official diagnose. In that case, I think your DS would be fine to answer NO to "history of" and "allergy" questions on DODMERB.

Note, I am not a physician but I did stay in a Holiday Inn Express last night. :)
 
Antibiotic allergies are not inherited. Amoxicillin is a narrow spectrum antibiotic that is useful in treating many childhood bacterial infections. I hate to have to prescribe something else when the first antibiotic of choice is amoxicillin.

Here is a link from the American Academy of Allergy, Asthma and Immunology that answers many FAQs regarding pencillin allergy. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/penicillin-allergy-faq


Another side effect of many antibiotics is sun sensitivity. If you are taking certain antibiotics, then are in the sun even for an hour or less, you can develop a red rash on the areas exposed. I have experienced this first hand many years ago when the doctor/pharmacist did not warn me, nor was it on the prescription.

Penicillin allergies are common, some are mild, some can be deadly. After a very severe reaction to penicillin when I was a small child, the doctor told my parents that if I was ever given penicillin again, it would kill me (I have a large scar from that episode). Later in life, both of my parents reacted to penicillin. I have never allowed doctors to prescribe penicillin to either of my DDs due to this family history.

A penicillin allergy is not a disqualifying condition for the SAs. As mentioned above, there are so many other antibiotics available.
 
Your DS may have never been diagnosed with an allergy if it was a one time incident. Most of the physicians around my area will not diagnose an allergy. They leave that to the specialist. They will, however, not any reactions to a medication if they required intervention. It could be that you were functioning with an understanding of an allergy but there were never an official diagnose. In that case, I think your DS would be fine to answer NO to "history of" and "allergy" questions on DODMERB.

Note, I am not a physician but I did stay in a Holiday Inn Express last night. :)

Very good point, I am now recalling that they did say “allergic reaction”. Not am actual diagnosis of an allergy. In fact, all those years ago, I recall a discussion about it just as you said. That to have an actual ALLERGY he would need to see an allergist. And be tested. It was decided that wasn’t needed as there are so many different options.

And @devildoc, one was raised hives that appeared and disappeared, the other a faint rash. Don’t recall which was what.

So yes...he has nit been medically diagnosed with an allergy. Good point!
 
DS is also stuck on the “Adverse reaction to ...”

As a toddler he “may” have had a reaction to penicillin. Symptoms showed up 12 days after last dose. Pediatrician said it could’ve been a Type III hypersensitivity to penicillin or Henoch - Schonlein purpura (HSP) a syndrome commonly affecting children preceding and infection. Both have similar symptoms of headache, joint pain and palpable purpura (awful looking purple splotches). It was a scary experience, but the symptoms ran their course and he was fine.

Since then the Doc has avoided prescribing penicillin, and on medical forms, I’ve checked off possible allergy to penicillin. DS has never had a problem with any other meds. An allergist told us even if he did a skin test, he would come up negative because a Type III reaction is a immune reaction that is delayed.

So...like the above posters, I feel like I’m opening a can of worms. The answer to the question isn’t really a “yes” or a “no,” but more of a “maybe.”
 
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