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Penicillin allergy and cellulitis — GPhC CRA MCQ

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ModerateInfectionsPenicillin allergy and cellulitisGPhC CRA

A GP asks for advice about an oral antibiotic for mild cellulitis in a patient with a documented immediate penicillin allergy. The patient is otherwise well and has no signs of sepsis. What is the most appropriate alternative?

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

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Correct answer: B — Clarithromycin

Flucloxacillin is usual first-line therapy for uncomplicated cellulitis, but it is unsuitable in an immediate penicillin allergy. Clarithromycin is a recognised alternative when macrolide therapy is appropriate. Co-amoxiclav and amoxicillin contain penicillin. Cefalexin may cross-react in some patients and should not be selected without assessing the nature and severity of the allergy.

Reference: NICE CKS; BNF