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Penicillin Allergy Summary Table(see following text for further detail and advice)
Penicillin Allergy Testing
Referral for Specialist Assessment
Desensitisation of Penicillin Allergic patients is a high risk procedure and should be reserved for serious acute clinical situations where no other antibiotic choice exists and where personnel and resources to manage same are present. Desensitization, even when effective, is a transient state and does not confer longterm tolerance. Unnecessary avoidance of Penicillin can present adversity and risk to patients and is reported to increase the cost and potential for drug related adverse effects (e.g. prolonged hospitalization, less effective microbial clearance, antibiotic related side effects and secondary infections such as Clostridium difficile and VRE). Delabelling of Penicillin Allergy status in selected patient groups and particularly those indicated above where it is especially recommended has potential benefits for individual patients and for healthcare systems. Allergy to Cephalosporins
References:
Reviewed March 2018 What is allergy to cephalosporins?The most common allergic reactions to cephalosporins are maculopapular or morbilliform rash, drug fever, and a positive Coombs' test. Urticaria, serum-sickness–type reactions (rash plus polyarthritis), and anaphylaxis are less common (see accompanying table).
Can you take cephalosporin if you are allergic to penicillin?Cephalosporins can be prescribed safely for penicillin-allergic patients.
What antibiotics can you take if you are allergic to cephalosporins?Patients with an allergy to cephalosporins can receive aztreonam (a monobactam and beta-lactam) without any concern of cross-reactivity, except if the cephalosporin allergy is to ceftazidime, because ceftazidime and aztreonam share a common R1 side chain that can result in cross-reactive allergic reactions.
Which antibiotic is contraindicated for a patient with a history of a Type 1 anaphylactic reaction to penicillin?Patients with symptoms suggestive of a Type I allergy should avoid cephalosporins and other beta-lactam antibiotics for mild or moderate infections when a suitable alternative exists.
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