Antibiotics have been revolutionary in the treatment of infectious diseases, especially when it comes to tick bites. Most tick-borne diseases can be treated with antibiotics when caught early on. That’s why they’re typically the first line of defense for managing an early-stage or active infection.
A problem arises when an individual with a suspected antibiotic allergy seeks treatment for a bacterial infection – such as a tick-borne illness. Emerging research on antibiotic allergies has led to questions as to whether potential antibiotic allergies may prove to be an obstacle to treatment in most people.
Because of this, an antibiotic challenge can be a beneficial tool in treating Lyme disease and other infections.
Antibiotic allergies in the general population
Approximately 10% of the population has a reported allergy to penicillin, but less than 1% experience a genuine reaction to penicillin-class antibiotics. On top of that, roughly 80% of patients diagnosed with a penicillin allergy may not experience a reaction ten or more years after the initial response. Usually, individuals will be reported as having an allergy to penicillin in childhood following an antibiotic reaction.
However, those who experienced a reaction at some point may not be truly allergic to penicillin, or the allergy may have resolved over time.
Those with a suspected antibiotic allergy may be treated with a less effective antibiotic. However, in rare cases, improper antibiotics can lead to antibiotic resistance or failure to treat an infection.
Even in instances where a patient does not have a genuine allergy to an antibiotic, they may still experience other adverse reactions that aren’t necessarily ‘allergic’ in nature. This includes gastrointestinal symptoms, fever, rash, and joint pain.
Still, determining whether or not someone is allergic to an antibiotic can be crucial for treating bacterial infections.
What is an antibiotic challenge?
An antibiotic challenge, or “antibiotic allergy challenge,” is a medically supervised test, usually carried out by a clinical immunology or allergy specialist. It is done to determine whether or not someone has a genuine antibiotic allergy. Antibiotics can be potentially life-saving or prevent long-term complications if no allergy is present.
Patients with a history of immediate antibiotic reactions will typically undergo a skin test first. This is done using a skin prick or intradermal test to evaluate for an allergy. If the individual exhibits a nonexistent to mild reaction to the skin prick, the specialist will usually proceed by administering oral medication and observing the patient for a response.
The procedure may take up to three hours, with the possibility of more extensive testing in case of a negative result. If the patient does not react to the challenge, then they may be advised to complete a 3-5 day course of the antibiotic to watch for delayed reactions.
Antibiotic challenge for tick-borne diseases
Penicillin is a prevalent, common option for Lyme disease treatment for children, pregnant people, and those who are sensitive to doxycycline. However, even alternatives may pose a supposed risk. Cefuroxime (Ceftin) is a cephalosporin antibiotic sometimes prescribed for Lyme disease that shows some chemical similarities to penicillin; patients allergic to penicillin may show a negative response to this as well. Individuals who suspect they have a penicillin allergy may avoid taking it or other treatment options, such as doxycycline, even when diagnosed with Lyme disease. This delay in treatment may lead to extensive, more severe problems as the disease progresses.
After a rigorous review of research, the International Lyme and Associated Diseases Society (ILADS) concluded that the “Consequences of an untreated chronic Lyme disease far outweighs the potential consequences of long-term antibiotic therapy.”
Accurate Lyme testing is key
Lyme disease is historically difficult to diagnose. Accurate urine, blood, or miscellaneous tests, like those provided by IGenex, combined with an allergy challenge, can provide a medical team of Lyme-literate doctors with a proper diagnosis. From there, the best possible course of antibiotics for each individual’s particular case can be determined, ensuring an effective treatment.
