Medicine: Penicillin Safety

Dangerous penicillin reactions, in patients with a special sensitivity to the drug, can range from fever, itching and swollen joints to sudden death from anaphylactic shock, an extreme allergic reaction.* Previous tests for penicillin sensitivity have been too slow and cumbersome for everyday use, but a new test is now available that quickly screens out potentially fatal cases.

Working at a U.S. Army hospital in Augsburg, West Germany, Major Vernon M. Smith put one drop of standard penicillin solution inside the lower eyelid of his subjects, and another drop on a light scratch made on the arm with a hypodermic needle. If within 20 minutes the eye did not become red, itchy or swollen, and if the inflamed area on the arm was no more than 1 cm. in diameter, it was considered safe to give the subject a full shot of the antibiotic. Only one man had a mild unfavorable reaction to the test itself; of more than 1,300 others, 25 gave a danger-signal reaction. One of these, a soldier suspecting venereal disease, ignored the warning, went to a private physician and demanded penicillin. He got it. Within five minutes he was dead.

Dr. Smith’s test fails to screen out patients who may have reactions that develop more slowly. But for them there was good news also. Two doctors at the U.S. Naval Hospital in Great Lakes, Ill. reported that injections of penicillinase (an enzyme that destroys penicillin in the body), given along with antihistamines, will clear up most cases of rashes, fever, swelling and painful joints caused by penicillin.

*Penicillin and aspirin, the two drugs used for the greatest number of patients, are also, the two that cause the greatest number of harmful reactions. Commonest aspirin reactions are allergic, especially in asthmatics; massive overdosing (usually seen in small children) may cause coma and death.