AOM – Penicillin Allergy
Mild/Moderate:
- Hives
- Single organ system
- Excludes side-effects such as vomiting and diarrhea
- Excludes family history but not individual history of penicillin allergy
Severe:
- Drug reaction with eosinophilia and systemic symptoms (DRESS)
- Stevens-Johnson syndrome (SJS)
- Anaphylaxis
Anaphylaxis Criteria
- Sudden onset of illness with involvement of skin, mucosa, or both (i.e. hives, itching, flushing, swollen lips/tongue, uvula)
- Plus at least one of the following:
- Sudden respiratory symptoms
- Sudden reduced blood pressure or end-organ dysfunction (hypotonia, syncope, incontinence, mottling)
- Plus at least one of the following:
- Two or more of the following after exposure
- Sudden skin or mucosal changes
- Sudden reduced blood pressure
- Sudden GI symptoms
- Reduced blood pressure or symptoms after exposure
- Age specific low systolic blood pressure or > 30% decrease in systolic blood pressure from baseline
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.