Amoxicillin Allergy (S3 Ep. 28)

Ten percent of Americans report an allergy to amoxicillin, yet most of these don't represent a true allergy. Today we discuss the types of drug allergies, how to determine if the allergy can be removed, and second line drugs for true PCN allergy with the goal of being outstanding stewards of antimicrobial stewardship. References American Academy of Pediatrics. (2013). The diagnosis and management of acute otitis media. Pediatrics, 131(3), p. e964-e999. doi:10.1542/peds.2012-3488 Chaudry, S.B., Veve, M.P., & Wagner, J.L. (2019). Cephalosporins: A focus on side chains and beta-lactam cross reactivity. Pharmacy, 7(3), p. 103. doi: 10.3390/pharmacy7030103 Mill, C., Primeau, M.N., Medoff, E., Lejtenyi, C., O’Keffe, A., Netchiporouk, E., … & Ben-Shoshan, M. (2016). Assessing the diagnostic properties of a graded oral provocation challenge for the diagnosis of immediate and nonimmediate reactions to amoxicillin in children. JAMA Pediatrics, 170(6), e160033. doi:10.1001/jamapediatrics.2016.0033 Shenoy, E.S., Macy, E., Rowe, T., & Blumenthal, K.G. (2019). Evaluation and management of penicillin allergy: A review. JAMA, 321(2), p. 188-199. doi:10.1001/jama.2018.19283 Shulman, S.T., Bisno, A.L., Clegg, H.W., Gerber, M.A., Kaplan, E.L., Lee, G., … & Van Beneden, C. (2012) Clinical practice guideline for the diagnosis and management of Group A Streptococcal pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 55(10), p. e86-102. DOI: 10.1093/cid/cis629 Vyles, D., Chiu, A., Routes, J., Castells, M., Phillips, E.J., Kibicho, J., & Brousseau, D.C. (2018). Antibiotic use after removal of penicillin allergy label. Pediatrics, 141(5), e20173466. doi: 10.1542/peds.2017-3466.

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Everyday application of clinical pearls in pediatrics that current evidence-based practice to the bedside for students and healthcare providers focused on caring for children. Visit thepedsnp.com for references, show notes, and disclaimer.