ABSTRACT
Joe is on a busy ward round with his consultant. The round is post-take and he has seen 23 patients so far. One of his patients is septic and needs a prescription for intravenous antibiotics. The consultant tells Joe to put him on ciprofloxacin. However, Joe is aware that the hospital protocol has changed and that ciprofloxacin is no longer the first-line antibiotic due to the increasing incidence of Clostridium difficile infection after its use. He suggests giving intravenous co-amoxiclav instead. The consultant agrees and appears impressed that Joe is up-to-date with the antibiotic guidelines. Joe prescribes the antibiotic. A few hours later he is called to the ward urgently as the septic patient is having difficulty breathing and has developed urticaria. He has had an anaphylactic reaction to co-amoxiclav. Joe realises that the allergies box on the drug chart states that the patient is allergic to penicillin. He puts out a medical emergency call and after further assessment the patient is transferred to ITU. After 24 hours on ITU the patient returns to the ward. No permanent damage has occurred.
