Spectrum: Local Antimicrobial Stewardship, for Bakersfield Memorial Hospital

Allergy to Penicillins

Note

Cephalosporins are the mainstay of surgical prophylaxis but are often changed to secondary agents due to a penicillin allergy.

Documented penicillin allergies do not preclude the use of cephalosporins and in most cases, they are tolerated without adverse events.

Non-Severe Penicillin Allergy

Vomiting, diarrhea, non-urticarial or non-pruritic rash are not true allergies.

These patients can safely receive cephalosporins.

Severe Penicillin Allergy

The following reactions are serious enough to warrant an alternative agent.

  •  Anaphylaxis

  •  Urticaria

  •  Laryngeal edema

  •  Bronchospasm

  •  Hypotension

  •  Pruritic rash

  •  Stevens-Johnson Syndrome (SJS)

  •  Toxic epidermal necrosis

  •  Drug reaction with eosinophilia and systemic symptoms (DRESS)

  •  Allergic interstitial nephritis