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Community-acquired pneumonia with penicillin anaphylaxis — SCE Acute Medicine MCQ

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ModerateRespiratory medicineCommunity-acquired pneumonia with penicillin anaphylaxisSCE Acute Medicine

A 48-year-old woman with asthma presents with breathlessness and fever. Chest radiograph shows left lower-zone consolidation. She is allergic to penicillin with previous anaphylaxis. CURB-65 score is 2. What is the most appropriate antibiotic approach?

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

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Correct answer: D — Use a non-beta-lactam regimen guided by local CAP policy and allergy status

Moderate-severity CAP requires prompt antibiotics, but previous penicillin anaphylaxis means beta-lactams should be avoided unless specialist advice supports use. Local antimicrobial guidelines usually specify alternatives such as a respiratory fluoroquinolone or combination regimen depending on risk. Waiting for cultures is inappropriate in a clinically significant pneumonia.

Reference: NICE NG138; Local antimicrobial guidelines