Algorithm to identify patients at low risk for penicillin allergy

This patient is definitely allergic to this medication.

This patient must avoid this medication.

They should have a medical alert bracelet, and have this information on their emergency information on their cell phone (if they have one).

This allergy should be added to their medical record:

• Family MD’s record

• Hospital record (hospital EMR)

• Pharmacy record (to be registered with pharmacare)

Clinical Pearls for long term management and reassessment:

Anaphylactic reaction:

Patients should be re-referred to an allergist 5 years after the diagnosis since this allergy can resolve over time

If previously diagnosed with an anaphylactic reaction, they can receive this medication if it is urgently required using a procedure called desensitization. This temporarily allows them to tolerate it, this requires an ID consult, and an allergy consult.

Severe delayed adverse drug reaction:

If instead, they had symptoms of a severe systemic or cutaneous adverse drug reaction then they must avoid this medication and further evaluation for this drug allergy is not indicated.