Addressing Drug Allergies for Family Physicians in Nunavik

As part of the "formation continue" series for family doctors in Nunavik, we delivered a talk on drug allergy on February 21, 2025. The focus was on a key issue in northern medicine: the high prevalence of penicillin allergy labels and the challenges this creates in patient care, particularly in remote regions where access to specialized allergy assessments is limited.

Many patients in Nunavik carry a penicillin allergy label, yet a significant number have never been formally evaluated. This presents significant difficulties, particularly in managing recurrent otitis media (acute otitis media), a common condition in the region. Without local allergy testing available, these patients face two options: they are either unnecessarily restricted from receiving first-line antibiotics, or they must be referred to Montreal for a formal evaluation, which is both logistically challenging and costly for patients.

During the session, we discussed strategies that family doctors can implement to assess drug allergies more effectively within their own practices. We also highlighted the potential for conducting oral drug challenges in appropriate cases, a process that can help to reduce unnecessary referrals to specialized centers and improve patients’ access to necessary antibiotics right at the local level.

The session was led by Dr. Michael Aw, a resident in Internal Medicine, under the guidance of Drs. Michelle Kwok and Michael Fein. The presentation was well-received by the attending physicians, who expressed interest in the practical approaches shared for improving care delivery in the region.

We would also like to extend a special thanks to Dr. Anne-Marie Milner for her invaluable role in organizing this event and ensuring its success.