Penicillin Allergy

When treating patients with a penicillin allergy, healthcare providers often need to select alternative antibiotics. If the allergy is not severe a cephalosporin (cefalexin) can be used.

Here’s a brief outline based on common medical conditions:

  1. Community-Acquired Pneumonia
    1. Standard: Amoxicillin
    2. Penicillin Allergy Alternative: Doxycycline
  2. Urinary Tract Infection
    1. Standard: Trimethoprim or nitrofurantoin
  3. Skin and Soft Tissue Infections
    1. Standard: Flucloxacillin.
    2. Penicillin Allergy Alternative: Clindamycin, TMP/SMX
  4. Streptococcal Pharyngitis
    1. Standard: Penicillin V.
    2. Penicillin Allergy Alternative:  Azithromycin
  5. Otitis Media
    1. Standard: Amoxicillin.
    2. Penicillin Allergy Alternative: Cefuroxime or TMP/SMX.
  6. Dental Infections
    1. Standard: Metronidazole + Penicillin or Amoxicillin.
    2. Penicillin Allergy Alternative: Clindamycin
  7. Syphilis
    1. Standard: Benzathine penicillin G.
    2. Penicillin Allergy Alternative: Doxycycline
  8. Diverticulitis
    1. Standard: Amoxicillin+Clavulanate
    2. Penicillin Allergy Alternative: TMP/SMX + Metronidazole
  9. Travellers Diarrhoea
    1. Standard: Ciprofloxacin or Norfloxacin
    2. Alternative: Azithromycin
  10. 9. Hospital-Acquired Infections
    1. Standard: Varies based on infection; penicillins and cephalosporins are common.
    2. Penicillin Allergy Alternative: Vancomycin, clindamycin, fluoroquinolones, or carbapenems, depending on the specific infection.

Notes:

  • Severity of Allergy: The choice of antibiotic also depends on the severity of the penicillin allergy (e.g., anaphylaxis vs. mild rash).
  • Local Resistance Patterns: Antibiotic choices may be influenced by local antimicrobial resistance patterns.
  • Consultation: In cases of severe or complex infections, consultation with an infectious disease specialist is advisable.

These recommendations may vary based on individual patient circumstances and emerging evidence. It’s always best to refer to the latest Therapeutic Guidelines for the most current recommendations.