Drug Allergy & Desensitization Program

Dr. Kimberly Blumenthal discusses drug allergies.

Our Goal: The Most Effective Treatment

At the Mass General Drug Allergy and Desensitization Program, our goal is to enable our patients to receive their full treatment safely (if truly necessary) despite a previous allergic reaction. For many of our patients, this had been impossible before evaluation and treatment at Mass General.

By providing expert evaluation of many different classes of drugs, we aim to ensure patients can safely complete therapy with the most effective medication to treat their condition. We most commonly evaluate patients who have possible adverse reactions to:

• Chemotherapy: for various forms of cancer
• Antibiotics: for various infectious diseases
• Aspirin: for heart disease
• Anesthetic agents, including both general and local anesthetics

Because the field is relatively new and expertise is lacking, few academic centers offer drug skin testing, challenges and desensitization. The novel nature of this drug allergy program combines clinical research methods with methods of quality improvement, process improvement, and economic analyses to improve patient outcomes. Our allergists' leadership and experience in clinical care and research, practice of staying abreast of the current literature and ability to offer drug challenges and desensitizations are key reasons why Mass General excels in managing drug allergies.

What to Expect

At your initial evaluation, your physician will discuss your medical history and any previous allergic reactions and conduct a thorough physical examination. We then will schedule skin and/or blood tests if appropriate.

If your history and/or testing confirms a drug allergy, we first consider whether you can take an alternative drug to treat your condition. If not, we may recommend a drug challenge or drug desensitization.

Drug Challenge: We will perform a drug challenge under close monitoring and supervision if your evaluation suggests you are unlikely to experience an allergic reaction to the medication. During the challenge, we will give you one to two doses of the medication in increasing amounts—carefully monitoring you for any reactions along the way—to ensure you can tolerate the full intended treatment dose.

Drug Desensitization: We will perform a drug desensitization if your evaluation suggests you are at significant risk for suffering an allergic reaction to the medication. Desensitization involves taking escalating doses of the medication at a very slow rate of progression until reaching the optimal dose. Safety is always our first priority. Because drug desensitization carries certain risks, we often complete the procedure in a Mass General inpatient unit. Our entire team's experience with drug desensitizations helps us to anticipate possible complications and address them quickly and successfully.

Where appropriate, we work with other world-class specialists at Mass General (e.g. oncologists, infectious disease specialists, cardiologists) to develop your treatment plan.

About This Program

Diagnosing & Treating Drug Allergy

The Mass General Drug Allergy and Desensitization Program offers a full range of diagnostic and therapeutic services at our main campus in downtown Boston. Allergists at Mass General Brigham Healthcare Center (Waltham) are available for initial consultations as well.

• We provide expert evaluation of many different classes of drugs. This is one of the only programs in the United States to test for allergies to drug types such as:
• Antibiotics
• Chemotherapy agents
• Steroids
• Monoclonal antibodies
• Local anesthetics
• General anesthetics

Depending on the patient's clinical history and whether an acceptable alternative drug exists, we may follow up initial skin and/or blood testing (when appropriate) with a drug challenge or drug desensitization.

Leadership in the Field

Aleena Banerji, MD, one of the founders of the Drug Allergy and Desensitization Program and an Associate Professor at Harvard Medical School, is known nationally for her expertise in this area. Through her research and clinical efforts, she has improved methods of evaluating drugs so we can administer a full dose of the most effective therapy for the patient's condition.

Kim Blumenthal, MD, MSc has clinical and research expertise in drug allergy, and specific interest in antibiotic allergies. She is recognized nationally for having created innovative approaches to the evaluation of penicillin and cephalosporin antibiotics in the hospital.