Not likely, but why take the chance? (Penicillin Allergy)

The other day my technician called for a consult at the counseling counter, as they regularly do.  I approached the counter and began my discussion with the middle aged lady about her antibiotic prescription for her prolonged sinus infection.  She had been prescribed Amoxicillin/Clavulanate (AugmentinTM) to treat her sinus infection.

So, we are at the counter and we are discussing why she is to take this particular antibiotic, how she takes it, what to look for to tell if it is or isn’t helping and a host of other important counseling information we discuss during a face-to-face counseling session with a patient about their new medication.  Before we are complete, I ask if she has any medication allergies.   For me, this is a redundant check, knowing that the patient should have already been asked this question 2 or 3 times today before getting to this point. 

Usually, a patient is asked about allergies by the nurse when they are taken into the exam room, by the prescribing physician when they are deciding which antibiotic is appropriate for this specific clinical condition and at the pharmacy intake counter if this is a new patient.  Furthermore, when the prescription is keyed into the computer profile there is a verification process that would flag the medication as inappropriate if there is an allergy to the medication, and then when the pharmacist fills or verifies the prescription we are able to check the allergy list on the patients receipt list.

Back to the question; I ask the patient if she has any allergies to any medications.  She states, yes, she is allergic to penicillin.  She states she thought it was in her chart and was sure the physician knew about it; however, she did not remember talking with the doctor or nurse about her allergies today.  I looked in the pharmacy computer and there was no documentation of penicillin allergy listed.  We have filled a few prescriptions for her over the past few years; however, she was not a regular monthly patient.

We discuss her allergy.  She states that she remembers her mother telling her that she had an allergic reaction to penicillin when she was in grade school.  She does not remember what the reaction was.   I followed up with a phone call to the patient’s physician.  The physician was skeptical of the allergy; yet grateful for the phone call.  He changed the antibiotic to azithromycin (ZithromaxTM), which is not related to penicillin’s yet is still effective for sinus infections.

We returned the amoxicillin/clavulanate prescription, processed the azithromycin prescription and then proceeded to have another counseling session at the counter.  Again, when we were done I verified that the patient does not have any allergies to azithromycin or its related antibiotics.  She stated no, only to penicillin’s. 

To learn more about specific antibiotics, or any other medication you may be interested in, please register to become amember of AudibleRxTM and then have full access to all of the Medication Specific Counseling SessionsTM.   Please visit the Medications Page at the AudibleRxTM website to see which counseling sessions are currently available.

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