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H. pylori therapy with penicillin allergy — GPhC CRA MCQ

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ModerateGastro-intestinal TherapeuticsH. pylori therapy with penicillin allergyGPhC CRA

A 38-year-old woman with confirmed H. pylori has a history of immediate facial swelling and wheeze after amoxicillin. A prescription is generated for omeprazole, amoxicillin and clarithromycin. She takes no other regular medicines. What is the most appropriate alternative?

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Correct answer: C — Contact the prescriber for a non-penicillin eradication regimen

Immediate swelling and wheeze suggest a serious penicillin allergy history. The amoxicillin-containing regimen is inappropriate and should be changed by the prescriber. Flucloxacillin is also a penicillin and is not a valid substitution. Antihistamine pre-treatment or dose reduction does not make re-exposure safe.

Reference: NICE CKS Dyspepsia; BNF