AB222. SOH21AS151. Severe intra-operative anaphylactic reaction to co-amoxiclav despite having a previous uneventful exposure
Anaesthesia Poster Session

AB222. SOH21AS151. Severe intra-operative anaphylactic reaction to co-amoxiclav despite having a previous uneventful exposure

Salma Abdelfatah Selim Khalil, Walter O’Brien, Ahmed Fareed

Department of Anaesthesia, Intensive Care and Pain Management, University Hospital Limerick, Dooradoyle, Limerick, Ireland


Abstract: Co-amoxiclav is used as a routine prophylactic antibiotic in surgical procedures. We present a case of a 45-year-old lady who was scheduled for elective repair of incisional hernia. Her past medical history was controlled hypertension with no previous drug or food allergy. On reviewing her past anaesthetic sheet, she was tolerant to the antibiotic with no reaction. In addition, on further questioning, she did mention receiving Co-amoxiclav several times orally without any complication. On the day of surgery, after induction of anaesthesia, the patient was given 1.2 g of Co-amoxiclav as per hospital protocol. Within 10 minutes, the patient developed severe bronchospasm with increased airway pressure and severe hypotension indicating anaphylactic shock. The patient was resuscitated and recovered successfully. The surgery was cancelled and the patient was provided a bed in the high dependency unit (HDU) for overnight monitoring and further investigations. Every theatre or ward that admit antibiotic should have a clear protocol for management of anaphylactic shock. Availability of adrenaline and timely delivery of the drug plays a core role in successful management of anaphylaxis.

Keywords: Co-amoxiclav; bronchospasm; airway pressure; hypotension; anaphylactic shock; adrenaline


Acknowledgments

Funding: None.


Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/map-21-ab222). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.


doi: 10.21037/map-21-ab222
Cite this abstract as: Khalil SAS, O’Brien W, Fareed A. AB222. SOH21AS151. Severe intra-operative anaphylactic reaction to co-amoxiclav despite having a previous uneventful exposure. Mesentery Peritoneum 2021;5:AB222.