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Transcript
Order for beta-lactam antibiotic
Penicillin allergy?
No
Implement
order
Yes
Yes
No
May try graded
challenge if unsure
Patient and/or
family do not
know/recall
reaction
Non-severe, non-IgE
mediated reaction
Delayed maculopapular rash
Itching
GI intolerance
Patient received an
antibiotic in that class
in the past without
reaction?
Type of reaction?
Severe, non-IgE mediated
reaction
Hemolysis
Stevens Johnson Syndrome
Toxic epidural necrolysis
IgE mediated
(type 1 reaction)
Urticaria (hives)
Angioedema
Anaphylaxis
Contact prescriber to use
alternative agent
Contact prescriber to:
1) Use alternative agent
2) Do penicillin skin test
3) Do graded challenge if felt to
be low risk of cross-reactivity