Benzylpenicilloyl-Polylysine Dosage

Usual Adult Dose for Penicillin Sensitization Testing

Puncture Skin Testing:

• The puncture technique should always be applied first.
• Skin testing is usually performed on the inner volar aspect of the forearm.
• A small drop of the skin test solution should be applied using a 22- to 28-gauge needle;

that needle should be used to make a single shallow puncture of the epidermis through
the drop of solution.

• A positive reaction consists of a pale wheal, sometimes with pseudopods, surrounding

the puncture site which develops within 10 minutes and ranges from 5 to 15 mm or
more in diameter; erythema and variable degrees of itching may surround the wheal.

• If a positive response is evident, the solution should be wiped off immediately.
• If the puncture test is negative or equivocally positive (less than 5 mm wheal with little

or no erythema and no itching) 15 minutes following the puncture test, an intradermal
test may be performed.

Intradermal Skin Testing:

• Prepare with an alcohol swab a skin test area on the upper, outer arm, sufficiently

below the deltoid muscle to permit proximal application of a tourniquet later (if
necessary).

• A volume of skin test solution sufficient to raise a small bleb of about 3 mm in diameter,

in duplicate at least 2 cm apart, should be injected intradermally using a 0.5 to 1 mL
syringe with a 3/8 to 5/8 inch long, 26- to 30-gauge short bevel needle.

• A like amount of saline or allergen-diluting solution should be injected with a separate

syringe and needle at least 5 cm from the antigen test site; this will serve as the control
site, which should be reactionless.

• Repeat the test if the control site exhibits a wheal greater than 2 to 3 mm; consultation is necessary if the same reaction occurs after the test is repeated.
• Most skin reactions will develop within 5 to 15 minutes; the skin test response should

be read at 20 minutes.

Interpretation of Intradermal Skin Test Response:

• Negative: No increase in size of original bleb or no greater reaction than the control site.
• Ambiguous: Wheal only slightly larger than original bleb with or without erythematous flare and slightly larger than control site; OR discordance between duplicate test sites.
• Positive: Itching and significant increase in size of original blebs to at least 5 mm; wheal may exhibit pseudopods and exceed 20 mm in diameter.

Comments: Do not administer the intradermally test to patients who have a positive reaction to the puncture test.

Use: Assessment of sensitization to penicillin (benzylpenicillin or penicillin G) in patients suspected to have clinical penicillin hypersensitivity.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration Advice:

• Skin test responses can be attenuated by interfering drugs (e.g., H1 antihistamines and vasopressors); use of this drug product should be delayed until the effects of such drugs have dissipated OR a separate skin test with histamine can be used to evaluate persistent antihistamine effects in vivo.
• Each ampule of this drug is for single patient use only and contains 0.25 mL, which is sufficient for both puncture and intradermal testing in duplicate in one patient; unused portions should be discarded.
• This drug product should be inspected visually for particulate matter and discoloration prior to administration.

Testing Technique:

• The manufacturer product information should be consulted.

Storage:

• Optimal storage is under refrigeration (2 to 8 Celsius).
• This drug product should be discarded if subjected to ambient temperatures for more than 24 hours or if particulate matter and/or discoloration are present.

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer