Despite penicillin's wide-usage, it also is responsible for a sizeable amount of adverse drug reactions (ADRs). This reaction can vary from a mild rash to life-threatening symptoms, such as anaphylaxis.
Penicillin is one of the most commonly used beta-lactam antibiotics. It inhibits the action of enzymes required for cross-linking of peptidoglycans in the bacterial cell wall, thus weakening the bacteria’s ability to maintain an osmotic gradient, which results in cell lysis.
Penicillin hypersensitivity is strongly associated with the presence of the HLA-B*55:01 allele in those with European ancestry. Due to the unpredictable and potentially severe nature of adverse drug reactions, it is recommended to consider testing for the presence of HLA-B*55:01 allele prior to initiating penicillin therapies. This test may also be used to further support a self-reported penicillin allergy. It is important to note that absence of the HLA-B*55:01 allele does not exclude a patient from possessing sensitivity to penicillin.
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