Penicillin Allergy

All drug-allergies must be specified on medication charts (with the patients reaction)
In TRUE penicillin allergy* ALL penicillins, cephalosporins and other beta-lactam antibiotics should be avoided

Appendix 1: Penicillin Allergy Poster

Antibiotics to be avoided in penicillin allergy

Amoxicillin Benzylpenicillin Co-amoxiclav (Augmentin) Flucloxacillin Penicillin V (phenoxymethylpenicillin) Piperacillin / Tazobactam (Tazocin) Pivmecillinam Temocillin 1st generation Cephalosporins Cefradine, Cefalexin

CONTRAINDICATED

CAUTION
Use with caution if non-severe allergy (e.g. minor rash or rash after 72 hours)

Antibiotics to be used with caution in non-severe penicillin allergy

2nd & 3rd generation Cephalosporins: Cefixime, Cefotaxime, Ceftazidime, Ceftriaxone, Cefuroxime Other beta-lactam antibiotics Aztreonam, Ertapenem, Imipenem, Meropenem

Antibiotics safe in penicillin allergy (not an exhaustive list)

Amikacin Azithromycin Ciprofloxacin Clarithromycin Clindamycin Colistin Co-trimoxazole Daptomycin Doxycycline Erythromycin Gentamicin Levofloxacin Linezolid Metronidazole Nitrofurantoin Ofloxacin Rifampicin Sodium Fusidate Teicoplanin Tetracycline Tigecycline Tobramycin Trimethoprim Vancomycin

CONSIDERED SAFE

*TRUE penicillin allergy includes anaphylaxis, urticaria or rash immediately after penicillin administration. In cases of INTOLERANCE to penicillins (e.g. gastrointestinal upset) or a rash occurring >72 hours after administration, penicillins/ related antibiotics should not be withheld unnecessarily in severe infection but the patient must be monitored closely after administration. The full guidance on antibiotic choice for patients with penicillin hypersensitivity is available at www.nhsgrampian.org/gjf - Chapter 5 Infections
NHS Grampian Antimicrobial Management Team (with thanks to NHS Tayside) June 2013 Review: June 2015