Amoxicillin Allergy Trials - Revision history

LiamG at 20:04, 12 May 2026

2026-05-12T20:04:31Z

← Older revision		Revision as of 20:04, 12 May 2026
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	~~H/O amoxicillin~~ allergy is rarely a true allergy. Get more information about what the reaction was, at what age it occurred, look at telemed pictures if you can, consult a pediatrician if they are little and consider amoxicillin challenge in the village OR bring them to ~~ER or~~ clinic in Bethel for this. Over 90% of the time there was not a true allergy ~~and~~ the flag was put on EMR because a parent reported a ~~h/o~~ rash or hives that was not really hives OR it was imported from our old medical record system and was not validated.		Amoxicillin allergy is rarely a true allergy. Get more information about what the reaction was, at what age it occurred, look at telemed pictures if you can, consult a pediatrician if they are little, and consider amoxicillin challenge in the village OR bring them to clinic in Bethel for this. Over 90% of the time, there was not a true allergy; often, the flag was put on EMR because a parent reported a history of rash or hives that was not really hives OR it was imported from our old medical record system and was not validated.

	~~==Example Auto text for RMT For Amoxicillin Trial==~~		Autotext: ..rmtamox
	~~'''~~Autotext:~~'''~~ ..rmtamox

	~~'''ASSESSMENT:'''~~
	*Patient’s history and medical records were reviewed and the patient does not have any evidence of a true allergy to amoxicillin.
	*CHA and family are OK with trial of Amoxicillin

	~~'''PLAN: '''~~
	*Recommend Amoxicillin trial in clinic today.
	*Document vitals, physical exam and good lung exam
	*Have epinephrine available.
	*Mix Amoxicillin
	*Draw up a CHAM, weight based dose of Amoxicillin.
	*Give the patient 1/10th of the dose in the clinic.
	*Have patient remain at the clinic for 20 minutes for observation. Caretaker is to alert the CHAs of any concerns.
	*After 20 minutes, if there are no problems, the patient may be given the rest of the dose of Amoxicillin.
	*Have patient remain at the clinic for another hour for observation in waiting room..
	*If there are no problems tolerating the test doses, then the patient may go home and continue medicine as prescribed.
	*If a rash or any concerns come up, the patient should be brought back to clinic and a telemed picture and RMT should be sent in for the provider to review and get a pediatric consult if required.
	*Give Amoxicillin Rash Handout to family to take home. Rash with amoxicillin is common in infants and young children and it is usually OK to continue the medicine unless the patient develops true hives, face swelling or difficulty breathing.

	==Resources/References==		==Resources/References==
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	* Khan, D. et al. [https://www.sciencedirect.com/science/article/pii/S0091674909015644?via%3Dihub Drug allergy.] J Allergy Clin Immunol 2010;125:S126-37.		* Khan, D. et al. [https://www.sciencedirect.com/science/article/pii/S0091674909015644?via%3Dihub Drug allergy.] J Allergy Clin Immunol 2010;125:S126-37.
	* Solensky, R. et al. [https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/drug-allergy-updated-practice-param.pdf Drug Allergy: An Updated Practice Parameter.] Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273. doi: 10.1016/j.anai.2010.08.002		* Solensky, R. et al. [https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/drug-allergy-updated-practice-param.pdf Drug Allergy: An Updated Practice Parameter.] Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273. doi: 10.1016/j.anai.2010.08.002
	* [[~~media~~:Stamping Out Amoxicillin Allergies - 8-6-2019.pdf\|Stamping Out Amoxicillin Allergies 2019]] (PowerPoint Presentation)		* [[Media:Stamping Out Amoxicillin Allergies - 8-6-2019.pdf\|Stamping Out Amoxicillin Allergies 2019]] (PowerPoint Presentation)
	* [[Media:Stamping Out Amoxicillin Allergy.pdf\|Stamping Out Amoxicillin Allergy 2013]] (PowerPoint Presentation)		* [[Media:Stamping Out Amoxicillin Allergy.pdf\|Stamping Out Amoxicillin Allergy 2013]] (PowerPoint Presentation)
	* [[~~media~~:~~Amoxicillin_allergy_trials~~.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]		* [[Media:Amoxicillin allergy trials.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]


	[[:category:YKHC Guidelines\|YKHC Clinical Guidelines]]		[[:category:YKHC Guidelines\|YKHC Clinical Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH: /* Example Auto text for RMT For Amoxicillin Trial */

2021-01-25T23:21:37Z

Example Auto text for RMT For Amoxicillin Trial

← Older revision		Revision as of 23:21, 25 January 2021
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	==Example Auto text for RMT For Amoxicillin Trial==		==Example Auto text for RMT For Amoxicillin Trial==
	Autotext: ..rmtamox		'''Autotext:''' ..rmtamox

	'''ASSESSMENT:'''		'''ASSESSMENT:'''

JenniferH: /* Example Auto text for RMT For Amoxicillin Trial */

2021-01-25T23:21:14Z

Example Auto text for RMT For Amoxicillin Trial

← Older revision		Revision as of 23:21, 25 January 2021
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	==Example Auto text for RMT For Amoxicillin Trial==		==Example Auto text for RMT For Amoxicillin Trial==
			Autotext: ..rmtamox

	'''ASSESSMENT:'''		'''ASSESSMENT:'''
	*Patient’s history and medical records were reviewed and the patient does not have any evidence of a true allergy to amoxicillin.		*Patient’s history and medical records were reviewed and the patient does not have any evidence of a true allergy to amoxicillin.
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	*If there are no problems tolerating the test doses, then the patient may go home and continue medicine as prescribed.		*If there are no problems tolerating the test doses, then the patient may go home and continue medicine as prescribed.
	*If a rash or any concerns come up, the patient should be brought back to clinic and a telemed picture and RMT should be sent in for the provider to review and get a pediatric consult if required.		*If a rash or any concerns come up, the patient should be brought back to clinic and a telemed picture and RMT should be sent in for the provider to review and get a pediatric consult if required.
	*Give Amoxicillin Rash Handout to family to take home. Rash with amoxicillin is common in infants and young children and it is usually OK to continue the medicine unless the patient develops true hives, face swelling or difficulty breathing.		*Give Amoxicillin Rash Handout to family to take home. Rash with amoxicillin is common in infants and young children and it is usually OK to continue the medicine unless the patient develops true hives, face swelling or difficulty breathing.

	==Resources/References==		==Resources/References==

JaneM at 20:05, 27 December 2020

2020-12-27T20:05:19Z

← Older revision		Revision as of 20:05, 27 December 2020
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	'''PLAN: '''		'''PLAN: '''
	*Recommend Amoxicillin trial in clinic today.		*Recommend Amoxicillin trial in clinic today.
			*Document vitals, physical exam and good lung exam
	*Have epinephrine available.		*Have epinephrine available.
	*Mix Amoxicillin		*Mix Amoxicillin

JaneM at 19:25, 27 December 2020

2020-12-27T19:25:05Z

← Older revision		Revision as of 19:25, 27 December 2020
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	*Give the patient 1/10th of the dose in the clinic.		*Give the patient 1/10th of the dose in the clinic.
	*Have patient remain at the clinic for 20 minutes for observation. Caretaker is to alert the CHAs of any concerns.		*Have patient remain at the clinic for 20 minutes for observation. Caretaker is to alert the CHAs of any concerns.
	*After 20 minutes the patient may be given the rest of the dose of Amoxicillin.		*After 20 minutes, if there are no problems, the patient may be given the rest of the dose of Amoxicillin.
	*Have patient remain at the clinic for another hour for observation in waiting room..		*Have patient remain at the clinic for another hour for observation in waiting room..
	*If there are no problems tolerating the test doses, then the patient may go home and continue medicine as prescribed.		*If there are no problems tolerating the test doses, then the patient may go home and continue medicine as prescribed.

JaneM at 19:22, 27 December 2020

2020-12-27T19:22:51Z

← Older revision		Revision as of 19:22, 27 December 2020
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	*Mix Amoxicillin		*Mix Amoxicillin
	*Draw up a CHAM, weight based dose of Amoxicillin.		*Draw up a CHAM, weight based dose of Amoxicillin.
	*Give the patient ~~one~~ 10th of the dose in the clinic.		*Give the patient 1/10th of the dose in the clinic.
	*Have patient remain at the clinic for 30 minutes for observation. Caretaker is to alert the CHAs of any concerns.		*Have patient remain at the clinic for 20 minutes for observation. Caretaker is to alert the CHAs of any concerns.
	*After 30 minutes the patient may be given the rest of the dose of Amoxicillin.		*After 20 minutes the patient may be given the rest of the dose of Amoxicillin.
	*Have patient remain at the clinic for another hour for observation in waiting room..		*Have patient remain at the clinic for another hour for observation in waiting room..
	*If there are no problems tolerating the test doses, then the patient may go home and continue medicine as prescribed.		*If there are no problems tolerating the test doses, then the patient may go home and continue medicine as prescribed.

JenniferH: /* Resources/References */

2020-11-20T09:01:25Z

Resources/References

← Older revision		Revision as of 09:01, 20 November 2020
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	* [[media:Amoxicillin_allergy_trials.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]		* [[media:Amoxicillin_allergy_trials.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]

	[[:category:YKHC Guidelines]]
			[[:category:YKHC Guidelines\|YKHC Clinical Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH: /* Resources/References */

2020-10-20T01:03:21Z

Resources/References

← Older revision		Revision as of 01:03, 20 October 2020
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	* Khan, D. et al. [https://www.sciencedirect.com/science/article/pii/S0091674909015644?via%3Dihub Drug allergy.] J Allergy Clin Immunol 2010;125:S126-37.		* Khan, D. et al. [https://www.sciencedirect.com/science/article/pii/S0091674909015644?via%3Dihub Drug allergy.] J Allergy Clin Immunol 2010;125:S126-37.
	* Solensky, R. et al. [https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/drug-allergy-updated-practice-param.pdf Drug Allergy: An Updated Practice Parameter.] Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273. doi: 10.1016/j.anai.2010.08.002		* Solensky, R. et al. [https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/drug-allergy-updated-practice-param.pdf Drug Allergy: An Updated Practice Parameter.] Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273. doi: 10.1016/j.anai.2010.08.002
	* [[media:Stamping Out Amoxicillin Allergies - 8-6-2019.pdf\|Stamping Out ~~Amoxcillin~~ Allergies 2019]]		* [[media:Stamping Out Amoxicillin Allergies - 8-6-2019.pdf\|Stamping Out Amoxicillin Allergies 2019]] (PowerPoint Presentation)
	* [[Media:Stamping Out Amoxicillin Allergy.pdf\|Stamping Out Amoxicillin Allergy 2013]]		* [[Media:Stamping Out Amoxicillin Allergy.pdf\|Stamping Out Amoxicillin Allergy 2013]] (PowerPoint Presentation)
	* [[media:Amoxicillin_allergy_trials.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]		* [[media:Amoxicillin_allergy_trials.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]

	[[:category:YKHC Guidelines]]		[[:category:YKHC Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH: /* Resources/References */

2020-10-20T01:02:38Z

Resources/References

← Older revision		Revision as of 01:02, 20 October 2020
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	* Khan, D. et al. [https://www.sciencedirect.com/science/article/pii/S0091674909015644?via%3Dihub Drug allergy.] J Allergy Clin Immunol 2010;125:S126-37.		* Khan, D. et al. [https://www.sciencedirect.com/science/article/pii/S0091674909015644?via%3Dihub Drug allergy.] J Allergy Clin Immunol 2010;125:S126-37.
	* Solensky, R. et al. [https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/drug-allergy-updated-practice-param.pdf Drug Allergy: An Updated Practice Parameter.] Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273. doi: 10.1016/j.anai.2010.08.002		* Solensky, R. et al. [https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/drug-allergy-updated-practice-param.pdf Drug Allergy: An Updated Practice Parameter.] Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273. doi: 10.1016/j.anai.2010.08.002
			* [[media:Stamping Out Amoxicillin Allergies - 8-6-2019.pdf\|Stamping Out Amoxcillin Allergies 2019]]
			* [[Media:Stamping Out Amoxicillin Allergy.pdf\|Stamping Out Amoxicillin Allergy 2013]]
	* [[media:Amoxicillin_allergy_trials.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]		* [[media:Amoxicillin_allergy_trials.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]

	[[:category:YKHC Guidelines]]		[[:category:YKHC Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

JenniferH: /* Resources/References */

2020-09-25T06:10:05Z

Resources/References

← Older revision		Revision as of 06:10, 25 September 2020
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	==Resources/References==		==Resources/References==
	*Vyles D et al. [https://~~pdf~~.~~sciencedirectassets~~.com/~~277741~~/~~1-s2.0-S1876285916X00137~~/~~1-s2.0-~~S1876285916304946/~~main~~.pdf?X-Amz-Date=20200925T053633Z&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Signature=4fe7c276567215ac3b569748653ddf7f1b87372b9186954381179830a15005f8&X-Amz-Credential=ASIAQ3PHCVTYV2PECNH6%2F20200925%2Fus-east-1%2Fs3%2Faws4_request&type=client&tid=prr-2a8e5ac0-8be6-4863-86e3-6521a2b6b174&sid=1df09d4f5a830646b348c40403310f84baf1gxrqa&pii=S1876285916304946&X-Amz-SignedHeaders=host&X-Amz-Security-Token=IQoJb3JpZ2luX2VjELT%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJIMEYCIQCKlSWl94cfgWIw1%2Fhhotki63SBMFarMRUGMbP%2FeLwtogIhAPKZIp3MKskHny8BF2FvEU%2FNdQYUd4dW8hlhNnGdGvAiKr0DCM3%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQAxoMMDU5MDAzNTQ2ODY1IgwE%2BWT2Gjr4ExDijqMqkQMZ5M0F5jZAFW20qgO4nD7KuhfpDniabWpJvpjvyINK9rUCNEbSEjAGnUp7UEavDr5Z9zDSQnN15bBD%2FBg8CCxbYP5vGza%2BKfSyeBEQ056ikO19Qfhu5qn5ZhNcryBbB8d118t8HQGemq0abaoNY9azG8ALgIIFHrJKVzZWIpVV9qggs3aFra94RalreJlDIyDKiLq7kmW%2BfUuJsnbrbWSkHKe4ftehS6Bu9JGZMJZ5U%2FDGzp4v1r7iHBxG91DzGZj6dZ32deG0xFhiwptGrZh4YxIP2L9NSoka1fiMvBs4TD%2BvWSkuFitUJsimTGrrspe5j4Aq6h0Hlai%2FrldUDQtVHfFQwA2zYUFb957O9cEwXpwKkQX1eIYiqDVBaNh0F8B75ZluIOfRZVUjHKWfxrA2DLOfFrZCoWTaTiIQH98xSb7MZYpavBhA%2BGbVtSpHIH3qmxrmiACxALLCq1yWzeY7zD5ZLoDbqadVBaaz87KCI3y0MaA46sBQLsZaOvdUMXSs%2FL%2BNRpBtyrqS3d0bCjxwKjD207X7BTrqARPgdjxSf6uX3ynESU%2F3L6gSfGir0jcQegiCPb7i5TqnL741uuouQgsS6dNyoSR7wIaZ3wjipB9oGnA9sBjP7PMbKix1vOzCeXCEAs%2FtRdFURHThyYJfjmSv%2Fs5SJ1IsN9Zvn1jjXkzFFGQz0OFAQEkZUWrqagrDfQnq0mfd8RNac5kCSj9IOitGvtb2W26QDSsd9Gw7gCbGCMWh4Nf9poTcfw5E6HLGBHyRm3Y9V%2BMquQ6rnVeaVPLPfiPGMnmV2lpWnFG1aSB8Yjl%2B8OP8YxC5gES1FB9ITl73UHvSvV9O9WkQhIHRwqTXnA%3D%3D&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&X-Amz-Expires=300&hash=59c441fdecdbf76f55a23dfd363a0b6d590213984169d84933a8cb3afbd67232 Parent-Reported Penicillin Allergy Symptoms in the Pediatric Emergency Department.] ''Academic Pediatrics.'' 2017. doi.org/10.1016/j.acap.2016.11.004.		*Vyles D et al. [https://www.sciencedirect.com/science/article/pii/S1876285916304946?via%3Dihubhttps://www.sciencedirect.com/science/article/pii/S1876285916304946?via%3Dihub Parent-Reported Penicillin Allergy Symptoms in the Pediatric Emergency Department.] ''Academic Pediatrics.'' 2017. doi.org/10.1016/j.acap.2016.11.004
	* Vyles D, et al. [https://pediatrics.aappublications.org/content/pediatrics/140/2/e20170471.full.pdf Allergy Testing in Children With Low-Risk Penicillin Allergy Symptoms.] Pediatrics. August 2017, 140(2)e20170471; doi.org/10.1542/peds.2017-0471		* Vyles D, et al. [https://pediatrics.aappublications.org/content/pediatrics/140/2/e20170471.full.pdf Allergy Testing in Children With Low-Risk Penicillin Allergy Symptoms.] Pediatrics. August 2017, 140(2)e20170471; doi.org/10.1542/peds.2017-0471
	* Salkind, A. et al. [https://jamanetwork.com/journals/jama/article-abstract/193846 Is This Patient allergic to Penicillin? An Evidence-Based Analysis ofthe Likelihood of Penicillin Allergy.] JAMA, May 16, 2001--Vol 284, No. 19.		* Salkind, A. et al. [https://jamanetwork.com/journals/jama/article-abstract/193846 Is This Patient allergic to Penicillin? An Evidence-Based Analysis ofthe Likelihood of Penicillin Allergy.] JAMA, May 16, 2001--Vol 284, No. 19.