Negative skin testing in patients with a positive prior history indicates that clinically significant amounts of IgE antibodies against penicillin are not present and the risk of anaphylaxis is extremely low. When an allergic reaction occurs in these patients it is usually not life-threatening.
A positive reaction with skin testing indicates that the patient is at significant risk for anaphylaxis to the administration of penicillin. In these patients, alternative antibiotic therapy should be given, if at all possible. If penicillin must be given, desensitization may be performed. Thereafter, penicillin must be given without significant interruption, or the risk of anaphylaxis will return

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