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Anaphylaxis to antibiotic — SCE Acute Medicine MCQ

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EasyAcute Rheumatological and Dermatological EmergenciesAnaphylaxis to antibioticSCE Acute Medicine

A 32-year-old woman is assessed on the acute medical unit. Minutes after intravenous co-amoxiclav she develops wheeze, lip swelling and hypotension. Oxygen saturation is 89% and urticaria is widespread. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most important immediate action?

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Correct answer: D — Give intramuscular adrenaline 500 micrograms

Give intramuscular adrenaline 500 micrograms is the best answer because airway, breathing or circulation compromise after allergen exposure is anaphylaxis requiring IM adrenaline. Perform needle decompression followed by chest drain insertion is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Antihistamines are not first-line treatment for airway or shock features.

Reference: Resuscitation Council UK anaphylaxis guideline