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Paediatric pharyngitis/tonsillitis with penicillin allergy

Appears 2×
Teaching point — how the wording changes the answer

For streptococcal pharyngitis with non-severe penicillin allergy, use cefalexin/cephalexin; for severe (anaphylactic) allergy use a macrolide (azithromycin/clarithromycin). Amoxicillin is contraindicated; doxycycline is avoided in young children.

Q89 Child with exudative tonsillitis and penicillin allergy; management?
Key clue Non-severe allergy -> cephalexin; severe -> macrolide
Show answer
Cefalexin (or a macrolide if severe anaphylaxis history)
Q191 Child with sore throat and lymphadenopathy, penicillin allergic; what to give?
Key clue Cephalexin acceptable alternative when macrolide not offered
Show answer
Cephalexin (macrolide if available)