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Guidelines
Beta-lactam Allergy Quick Sheet

Beta-lactam Allergy Quick Sheet

Initial Evaluation

  • Discussing with the patient can help to rule out serious reactions or adverse reactions that were mislabeled as allergies
  • Document your discussion in medical record

Pharmacist can assist with looking up medication history at Scripps

  • ~80% of patients will no longer be PCN-allergic after 10 years
  • Skin testing or challenge may help confirm an allergy.

Penicillin Reaction Type

Severe non-IgE (Type II-IV)
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  • Stevens-Johnson Syndrome (SJS)
  • Toxic Epidermal Necrolysis (TEN)
  • Drug Rash Eosinophilia Systemic Symptoms (DRESS) Syndrome
  • Erythroderma
  • Acute Interstitial Nephritis (AIN)
  • Serum sickness
  • Hemolytic anemia

Severe IgE-mediated (Type I)
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  • Anaphylaxis
  • Angioedema
  • Laryngeal edema
  • Hypotension

Mild Reaction
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  • Itching
  • Rash
  • Maculopapular (delayed) rash
  • Hives
  • GI/intolerance
  • Unknown (confirm NO severe rxn)

Revision and Approval

Last Reviewed July 2023