Spectrum: Local Antimicrobial Stewardship, for Prisma Health-Midlands

Beta-Lactam Allergy

Minor Penicillin Allergies

Minor Penicillin Allergies

Nonspecific or maculopapular rashes, intolerance, etc.

Consider a cephalosporin, such as:

Cefuroxime 500mg PO Q12h

OR

Cefdinir 300mg PO Q12h

Cross-reactivity with these higher generation cephalosporins is low (<3%) in patients with minor penicillin allergies and the benefit from beta-lactam antibiotics outweighs the potential risk in these patients

Serious Penicillin Allergies

Serious Penicillin Allergies

Anaphylaxis, angioedema, breathing problems, and hives

Consider a respiratory fluoroquinolone, such as:

Levofloxacin 750mg PO Q24h

In the absence of prior exposure to fluoroquinolones in the past 12 months

Consider consultation with an infectious diseases specialist or PHASST for optimal empirical therapy or evaluation for penicillin allergy skin testing