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Alternative Therapy for Severe Penicillin Allergies

Avoid cephalexin due to same side-chain as penicillin. Other cephalosporins may be tolerated:

  • Ceftriaxone: Cystitis or pyelonephritis: 50 mg/kg/dose IV or IM q24h (max: 2000 mg/dose).

OR

  • Cefixime: 8 mg/kg PO (max: 400 mg/dose).

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.

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