skip to main content

Penicillin Allergy Delabelling — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAntimicrobial StewardshipPenicillin Allergy DelabellingSCE Infectious Diseases

A 30-year-old woman presents with a painless genital ulcer and bilateral non-tender inguinal lymphadenopathy. Her partner was recently treated for syphilis. Dark-field microscopy is positive. She has a documented allergy to Penicillin (childhood rash only — details unclear). She is not pregnant. What should be considered before selecting treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Penicillin allergy verification as the next step

Penicillin allergy delabelling is increasingly recognised as an important antimicrobial stewardship intervention. Many patients labelled as penicillin-allergic (especially those reporting childhood rashes) do not have true IgE-mediated allergy. For syphilis, Benzathine Penicillin G remains the gold standard. If the allergy history is vague (childhood rash, uncertain details), allergy assessment (skin testing ± oral challenge) should be considered to enable first-line therapy. BSACI guidelines support structured allergy delabelling. Doxycycline is the validated alternative if true allergy is confirmed.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/infections