617. Are You Really Allergic to Penicillin?
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They say that the new year is a good time to express gratitude. So here's what I am most grateful for right now. My health. For much of last year, I was sick. It started in the spring with a cough that turned into a respiratory infection. That turned into a whole other thing. And for a few months, I was miserable. It hurt to talk or swallow. Every time I laughed, it would trigger a coughing fit, which is a problem because I like to laugh. Thanks to the cough, I couldn't sleep through the night. I also had some ferocious night sweats and crazy dreams. During the day, my entire body ached like I'd been hit by a car. Also, no appetite, no energy. Physically, it was the worst few months of my life. But at least I got a story out of it.
This one. Today's episode is about penicillin. You may remember the famous story of how penicillin was discovered accidentally nearly 100 years ago by Alexander Fleming. This was at St. Mary's Hospital in London. Fleming was just returning from holiday. In his lab, he had left behind a petri dish where he'd been culturing bacteria, and he found some mold growing in the dish. Interestingly, where the mold grew, the bacteria did not. It turned out that this mold juice, as Fleming called it, could kill many types of bacteria, not just the one growing in that Petri dish. Penicillin was eventually used to treat strep throat, meningitis, dental infections, gonorrhea, and much more. It came to be thought of as something like a miracle drug.
The penicillins are in fact a family of antibiotics, including amoxicillin, ampicillin, methicillin, and several others. All these years later, they are still among the safest, cheapest, and most reliable drugs around. They have saved hundreds of millions of lives. Even with all the new antibiotics since then, penicillin is still prescribed at the highest rate of any antibiotic. But there's one big problem. 10% of Americans, more than 30 million people are allergic to it. At least that's what the conventional wisdom says. But the new year is also a good time to tear down conventional wisdoms, especially if they are disastrously wrong. And this one is. So today on Freakonomics Radio, why do so many of us think we have this allergy?
Huh. This patient told me they were allergic to penicillin. Oh, it's that your mom told you when you were a kid. Well, what happened? Oh, you don't even know what happened?
What should be done about all these false positives?
We should be screaming from the rooftops. This is a misdiagnosis.
And what about all the other allergy controversy we hear about, like food and environmental allergies? How bad is the confusion there?
It's bad. It's one of the reasons I can't tell you how many people actually have an allergy.
What can we tell you? A lot, starting now.
This is Freakonomics Radio, the podcast that explores the hidden side of everything with your host, Stephen Dubner.
OK, here is the startling fact that I recently learned. While it is true that around 10 percent of Americans believe they are allergic to penicillin, fewer than 1 percent actually are. How can there be such a huge gap? And what are the costs of that gap, the medical and economic and social costs? Those are some of the questions we will try to answer today, starting with this new friend of mine.
Elena Resnick. I'm an allergist and immunologist.
And how does one get interested in allergy and immunology?
I always knew I wanted to be a doctor. My dad's a doctor, and there was never any doubt about that. I was lucky to have a lot of great mentors along the way. My mentor in college, Jerry Groupman, who's up at Harvard, was very instrumental in my choices. I worked in his lab for four years. applied to medical school, thought I wanted to be a hematologist oncologist like him, explored that field. And later into my residency, I explored allergy immunology, which has fascinating medicine and amazing potential to make people feel better.
Give me a little bit of fascinating medicine. I find almost every branch of medicine pretty fascinating, in part because there's so much mystery still. I mean, as much as we've learned, there's still so much that we don't know. So what was it that really got you hooked there?
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