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Cellulitis penicillin allergy — GPhC CRA MCQ

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ModerateInfectionsCellulitis penicillin allergyGPhC CRA

A 58-year-old man with mild lower-leg cellulitis is prescribed flucloxacillin 500mg four times daily. He reports previous immediate wheeze and lip swelling after penicillin. He is afebrile, observations are stable and has no abscess. What is the most appropriate alternative?

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Correct answer: D — Contact the prescriber to consider clarithromycin or another suitable non-penicillin option

Immediate wheeze and lip swelling suggest IgE-mediated penicillin allergy, so flucloxacillin and amoxicillin should be avoided unless specialist advice indicates otherwise. Mild cellulitis still usually requires systemic antibiotics. A prescriber should select a suitable non-penicillin alternative based on guidance and patient factors. Topical therapy is inadequate for established cellulitis.

Reference: NICE CKS Cellulitis; BNF