Serious Type II-IV Reaction

• Serum sickness

• Stevens-Johnson syndrome

• Toxic Epidermal Necrolysis

• Drug Rash Eosinophiia Systemic Symptoms (DRESS)

Avoid using penicillin, cephalosporin or carabapenem

Use alternative agent based on appropriate coverage or contact Peds ASP/ID

If clinical indication for beta-lactam is highly recommended, contact Peds ID and Allergy/Immunology