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Dr. Andrew Rynne

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What are the medications for tonsillitis that can be given to a child with penicillin allergy?

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Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 1962 Questions

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Posted on Tue, 4 Sep 2018 in Child Health
Question: My grandson is 4 and had a + strep test
He is allergic to PCN and is "impossible"to get any oral medication into him
What IM shot is an option - that would be better than the daily struggle, spattering and fear of aspiration
Any creative thoughts are welcome
We heave tried every possible "disguise" of medication in shakes etc and any form of "bribery"
H-E L-P!!
doctor
Answered by Dr. Antoneta Zotaj 1 hour later
Brief Answer:
Several options explained

Detailed Answer:
Hello,

Tonsillitis is a very common infection in children and it is also a self limiting one which means the body will heal itself. Sometimes antibiotics are needed to help speed the healing and Penicillins are the first choice. Because he is allergic to them it is obvious he cannot take them. There are other medications that can help called Cefalosporines which are another group of antibiotics and that can also be given him. They have a 10% chance of cross reaction to penicillin so they might be used in case of penicillin allergy patients as long as it was not a severe allergy (with face swelling,

Macrolides would be the choice in patients with severe Penicillin allergy and a few of them are injectable also like Clarithromycine powder for solution. Another one that is an option is Clindamycine for injection. Both of these are antibiotics with a very broad spectrum and even though they are effective in tonsillitis they might not be primarily recommended for tonsillitis.

To conclude i would say:
1. even bacterial tonsillitis from strep infection is self limiting if it is not complicated so giving plenty to drink and rest and antipyretic (paracetamol and ibuprofen regularly as suppositories) will be enough for most children to heal totally in 5-7 days
2. if antibiotics are necessary and the child has a mild allergy to penicillins than he can be given injectable cefalosporines.
3. in severe allergy to penicillin and antibiotics are necessary than injectable clarithromycine or clindamycine are possible options, but remember the risks of the very wide spectrum they have and side effects.
4. please take all these with your doctor so he can explain you more, and if any of them is a good option in the case of your grandson and which.

I hope this is helpful and answers to your question but please feel free to reply in case more clarification is needed on this.

Kind regards,

Antoneta Zotaj, MD
Above answer was peer-reviewed by : Dr. Kampana
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