Penicillin Allergy and Cephalosporins

Another holiday, another staph infection! Why do these things seem to happen on something EVE. At 6pm on the day before Turkey Day, we discover that Tanner has several bumps on his body that look infected (I'll spare you the details). Thankfully, we have a pediatric urgent care facility just a few blocks from our house, right next to the Qdoba! After some queso burritos and cheese quesadillas, my husband takes the little guy over. I had a few last minute items to pick up at the grocery store for the next day's feast so we reconvene at home after a successful diagnosis and a trip to Walgreens for some antibiotics. We're about to give him his first dose of cephalexin when my husband says, "The pharmacist noted that Tanner has a penicillin allergy so she wanted me to know that this is a relative of penicillin. Should we give it to him?"

Um, no. Well, let's look it up but I'm thinking... no. A quick Google search on "cephalexin and penicillin allergy" brings up an article, "Cephalosporins can be prescribed safely for penicillin-allergic patients." Cool. But then I read the article, which says "Cephalothin, cephalexin, cefadroxil, and cefazolin confer an increased risk (10% cross-reactivity) of allergic reaction among patients with penicillin allergy. Cefprozil, cefuroxime, cefpodoxime, ceftazidime, and ceftriaxone do not increase risk of an allergic reaction."

At this point, it's 10pm and we decide to wait until morning and call our regular pediatrician. We give him the lowdown... we didn't want to bother you on the day before Thanksgiving, blah, blah, blah. Dr. Z says, "Next time, just call me! You were right not to give it to him...."

Perhaps the urgent care doc did not quite understand what my husband meant by penicillin allergy. Perhaps she thought he got a few hives or something. My husband says, "Maybe I wasn't clear that he had an anaphylactic reaction." It doesn't really matter.

We have to be advocates for our kids. A doctor may see 50 patients a day. Accidents happen. We know his case history better than anyone else. More importantly, to me, Tanner is not just a case or a symptom. Bottom line, we care about him more than anyone else.

It was a close call, a lesson learned, and another thing to be thankful for... Happy Thanksgiving!