CASE STUDY: PENICILLIN ALLERGY
Dispensing 2 (Laboratory) - Salamat, K.
Group 2 | Adorador, Allarey, Hidalgo, Jamin, Javen, Palines, Pineda, Villabroza
CASE STUDY SCENARIO:
SW is a 20-year-old girl who comes to your
pharmacy's urgent care clinic. She
complains an allergic reaction having
symptoms of mild rash and itching, sore
throat, headache, and nausea. She
previously went to her doctor's clinic and
was prescribed penicillin for her strep
throat. You found out that SW is allergic to
penicillin.
Question: Since SW has a penicillin
allergy, what antibiotic would you suggest to
be prescribed by the doctor to treat SW's
strep throat?
KEY POINTS TO REMEMBER
Strep Throat
● It is a bacterial infection that causes
inflammation in the throat. Common
symptoms include a sore throat,
fever, and white or yellow tonsil
patches.
● It is caused by bacteria called group
A Streptococcus (group A strep).
● Penicillin or amoxicillin are
considered the best first-line
treatments for Strep throat.
● A 10-day course treatment.
PENICILLIN ALLERGY
● Allergy to penicillin is an example of
Type B (Bizarre). It is an
immunologic or hypersensitivity
reaction. Additionally, it is also
classified as Type 1 (Immediate or
Anaphylactic Immune Response.
● For people with a penicillin allergy,
treat Strep throat with either a
narrow-spectrum cephalosporin
(such as cephalexin or cefadroxil),
clindamycin, azithromycin, or
clarithromycin. Note that
resistance to azithromycin and
clarithromycin has been reported.
● Since SW is allergic to penicillin,
alternative agents can be used.
These include:
First-generation cephalosporin (if the
patient is not anaphylactically sensitive to
penicillin or amoxicillin) like Cephalexin
● MOA: inhibit bacterial cell wall
synthesis and have the same mode
of action as other beta-lactam
antibiotics (such as penicillins).
They disrupt the synthesis of the
peptidoglycan layer forming the
bacterial cell wall. The
peptidoglycan layer is important for
cell wall structural integrity.
ADDITIONAL INFO:
When it comes to strep throat, cephalexin
is more effective than amoxicillin. Even
so, Amoxicillin remains the
recommended first-line treatment option
for strep throat, and cephalexin is the
choice for a patient with a penicillin
allergy.
Clindamycin
● MOA: It is a macrolide antibiotic
that acts by inhibiting bacterial
protein synthesis at the level of the
50S ribosome.
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CASE STUDY: PENICILLIN ALLERGY
Dispensing 2 (Laboratory) - Salamat, K.
Group 2 | Adorador, Allarey, Hidalgo, Jamin, Javen, Palines, Pineda, Villabroza

● Clindamycin may be useful if you're

unable to take penicillins and
cephalosporins to treat your strep
throat infection.

Azithromycin or Clarithromycin
● MOA: It is a macrolide antibiotic
that acts by inhibiting bacterial
protein synthesis at the level of the
50S ribosome.
● It can also be used as an
alternative antibiotics to treat Strep
throat for patients with penicillin
allergy.

References:

https://www.drugs.com/medical-answers/be
st-antibiotic-treat-strep-throat-3121657/

https://www.medicalnewstoday.com/articles/
z-pack-for-strep-throat