Summary Writer: Dennis Neuen
Script Writer: Alice Grey
Editor: Alice Grey
Interviewee: Alice Grey
Antibiotic allergies are commonly reported and pose a challenge for doctors on the wards.
James talks to Dr Alice Grey to help give junior doctors a guide to making safe and sensible decisions about a patient with a reported penicillin allergy – the most commonly reported medication allergy.
Alice Grey is an Immunology & Allergy Advanced Trainee. Her training program has taken her to Royal Prince Alfred, Campbelltown, Liverpool and Concord Hospitals.
With Dr Alice Grey, Advanced Trainee in Immunology and Allergy, Sydney, Australia
Antibiotic allergies are commonly reported and pose a challenge for junior doctors. On the one hand, many patients who report allergies will not in fact be allergic to the medication in question. They may unnecessarily miss out on treatment with the most appropriate antibiotic. There is evidence that the over-reporting of antibiotic allergies has other negative effects – for example, surgical site skin infections are more common in patients with a reported penicillin allergy. On the other hand, administering a culprit medication to a patient who is truly allergic will result in an allergic reaction which can be dangerous and even life-threatening. Often the junior doctor will be the first port of call for the patient who reports an antibiotic allergy and it can be difficult to determine what the correct course of action is. This podcast aims to give junior doctors a guide to making safe and sensible decisions about a patient with a reported penicillin allergy – the most commonly reported medication allergy.
Case 1 – You’re a junior doctor working after hours on the wards and you are paged by a nurse to see a 54 year old male with cellulitis with a background history of type 2 diabetes and hypertension. He has been charted for IV flucloxacillin. You notice he has a documented allergy to penicillin and so the first dose was withheld in Emergency Department. The nurse is wondering whether to still give him his IV flucloxacillin. What do you do?
Case continued – 10 years ago, the patient had some “tablets” for a chest infection. A few days later, he had a ‘red and blotchy’ rash that went away without treatment.
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