Ep. 255 Antibiotic Allergy vs. Intolerance: Understanding Patient Risk with Dr. Cosby Stone

When should an antibiotic allergy actually be tested? In this episode of the BackTable ENT Podcast, guest host Dr. Basil Kahwash, an allergist and immunologist at Ohio ENT & Allergy, sits down with Dr. Cosby Stone, an allergist and immunologist at Vanderbilt University Medical Center, to discuss antibiotic allergies and how to distinguish true allergies from intolerances. --- SYNPOSIS Dr. Stone breaks down common misconceptions around antibiotic allergies, with a focus on penicillin and cephalosporins. The conversation explores how these allergies are evaluated, including when skin testing is appropriate, why inaccurate allergy labels matter, and how confirmed allergies should be managed long term. They also dive into more advanced topics such as drug desensitization, current research in the field, and where the future of drug allergy evaluation is headed. --- TIMESTAMPS 00:00 - Introduction 01:03 - Understanding Antibiotic Allergies07:28 - The Importance of Accurate Allergy Diagnosis10:55 - Key Questions for Diagnosing Allergies17:10 - Implementing Allergy Testing in Healthcare Settings19:06 - Identifying Severe Allergic Reactions26:31 - Interpreting Allergy Skin Testing Procedures33:17 - Penicillin and Cephalosporin Cross-Reactivity37:15 - Drug Desensitization: Indications and Process40:30 - Prognosis and Long-Term Outcomes of Drug Allergies47:22 - Conclusion and Final Thoughts --- RESOURCES Dr. Basil Kahwash https://www.ohioentandallergy.com/physicians/basil-kahwash-md/ Dr. Cosby Stonehttps://www.vanderbilthealth.com/doctors/stone-cosby