An increasing number of patients have acquired a hypersensitivity to the systemic administration of penicillin, in the form of a skin eruption, fever or even of an acute anaphylactic reaction which has occasionally proved fatal. The patient should always be asked about any previous allergic reaction to penicillin before treatment is commenced. If such a history is given penicillin should not be prescribed, even if a different form had previously been used. Patients who suffer from bronchial asthma or who are hypersensitive to other drugs are particularly liable to become allergic to penicillin. A mild hypersensitivity state developing during treatment may be controlled by an antihistamine drug; a more severe reaction will demand a change of antibiotic. Desensitisation is rarely practicable and even if successful may only be temporary. Anaphylactic shock is treated by the immediate intramuscular injection of 0.5 ml. 1: 1000 solution of adrenaline and if this is not rapidly effective, by the intravenous injection of 100mg. of hydrocortisone hemisuccinate.
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