Anaphylaxis from Augmentin (amoxicillin) after pneumonia, no previous penicillin allergy.

[Aquablue80]

Hi all,

Would really appreciate some advice.

A couple of days ago I developed anaphylaxis after taking an augmentin antibiotic tablet. I'm 42 and have no history of allergy to penicillin, have always been able to take it.

I recently had bad pneumonia and was on a 3 week course of augmentin and had restarted a new course after I felt symptoms coming back. I read in the augmentin leaflet that there can be a rare interaction between pneumonia and augmentin causing anaphylaxis and wondered if anyone else had experienced this?

I am in London, UK and am 42 yr old female. I took a tablet and after about 20 mins extremely itchy bright red rash spread over my whole body and inside my ears, on my scalp. There were some target lesions but it turned into bright red all over my body. I started sweating profusely and vomiting and my chest went tight. I felt like I was going to have diarrhoea. I called an ambulance but they said I did not need it at this point and to call 111 (another government medical advice line).

I felt like I was going to pass out so used all my energy to get an uber. In the uber I started shaking a lot but the driver was very nice talking to me the whole time. I felt like my body was lurching if that makes sense and that it was getting worse but I couldn't control it and I was just going to go to sleep.

When I got to the hospital I noticed my legs and arms were going red and my voice went very hoarse. My hands and feet were getting puffy and tight.They said I was having a severe allergic reaction and took me straight into the ICU and put me on the heart monitor and did a tracing. The nurse said my heart 'was not very good' but asked if I normally ran a high Blood Pressure (isn't anaphylaxis usually low BP?).

The doctor looked in my throat and listened to my chest and said it was fine and I was going to be ok. They gave me Cortisone and some other medicines through a canula in my hand. My chest was getting very tight and I found it painful to breathe in and out in the centre of my chest. They said they would give me something to help with the itching too.

After a while when I was sleepy the doctor looked at my legs as the redness was going down and said I could go home and sleep and to take it very easy next few days. The emergency room was extremely busy and short-staffed so I think that's why they sent me home after a couple of hours rather than monitor me overnight in the hospital.

When they discharged me I still was feeling tight in my chest and quite unwell. Since it happened I still have a tight chest and rash, the GP has given me an inhaler. They don't prescribe Epipen's in the UK for Penicillin allergy but advise avoidance and carrying a card instead.

I'm taking Fexofenadine and the GP advised I can add Zyrtec. The GP said augmentin has a short half-life and should be out of my system after 12 hours but it's normal that I could still be experiencing residual symptoms. The advice I would like to know is:

1) Do people in the US, or people in the UK if they've gone privately recommend carrying an Epipen for severe penicillin allergy? It came on so quickly I am very scared that if it happened again and I did pass out I wouldn't have anything for other people to help me. 

2) I don't think they gave me Adrenaline as I didn't receive an injection to the thigh or an IV infusion, it was all given through my inner elbow and hand. Something was 'flushed through' I heard them say that but they were more working on me than talking with me and I was very sleepy. The report from the emergency room doesn't list the medications they gave or a diagnosis it just states severe penicillin allergy. Does this mean it wasn't Anaphylaxis if they didn't give Adrenaline? 

3) I am very scared that it will happen again now and wondered if you have a new severe penicillin allergy if other things could set off anaphylaxis that haven't previously either? Because I believe you're more prone to this response if you've had it once. Can anyone advise as to whether I will be able to live normally if I continue to avoid penicillin as I've been told to do now for the rest of my life?

I really really appreciate you reading this and any advice as it was very scary and it is all new. I also posted this message on reddit so apologies if anyone has read this in more than one group.

[Shiloh1]

Augmentin contains polyethylene glycol. If you received the COVID-19 vaccines which contain polyethylene glycol, Pfizer’s and Moderna’s, you were likely sensitized to PEG as it is a vaccine component. If that is the case, it is very important to verify through testing as PEG is everywhere in the environment and difficult to avoid. PEG is a known allergen with cases of severe reactions on the increase in the population due to it’s widespread use, a population baseline of 72% having preexisting antibodies, and a population level exposure to PEG through the COVID-19 vaccination program. As a host of medicines and other products contain PEG, extreme vigilance is required by anyone with a severe allergy to PEG.

[Aquablue80 in reply to Shiloh1]

Thanks Shiloh1. This is incredibly useful information and I will follow up. I am waiting for my referral to the allergy clinic in the UK which may take months but I think I will need to go privately having read your message to get answers sooner. Really appreciate you taking time to write to me. I did have 3 Pfizer vaccines. I did also have pneumonia which is what I was treating with the augmentin which can also cause this reaction it says on the leaflet so I'm not at the bottom of this yet. It does sound from what you're saying that it would be advisable for me to have an Epipen so that is my next port of call, as again I would need to be prescribed that in the UK privately as they say they will not give it for penicillin allergy.