Algorithm to identify patients at low risk for penicillin allergy

Now that you have completed these questions, which category does your patient fall into?

1) Acute Symptoms:

 Onset: 2 h or less after most recent dose was administered

 One or more symptoms of:

 Duration of symptoms: Less than 24 h after discontinuing antibiotic

2) Delayed symptoms

 Macular rash OR Maculopapular rash OR Urticaria

 Onset: After 1st day of therapy or Over 2 h after most recent dose

 Duration of symptoms: Longer than 24 h

 None of the severe symptoms from the prior page of questions

3) I don’t know if it is acute or delayed because:

 There is no history OR

 There is a poor historian, OR

 the individual providing the history did not see the rash OR

 Does not fit into acute or delayed symptom categories