Which action is the immediate management step for penicillin-induced anaphylaxis?

• A. Stop penicillin; assess for anaphylaxis; administer epinephrine if signs of anaphylaxis; summon help.
• B. Continue penicillin and monitor for reaction.
• C. Switch to a different antibiotic without allergy testing.
• D. Give antihistamines and resume penicillin once symptoms subside.

Answer: (A)

Recognizing and treating penicillin-induced anaphylaxis requires acting quickly to remove the trigger and support the patient’s breathing and circulation. The immediate step is to stop the penicillin to prevent further exposure, then assess for symptoms of anaphylaxis. If signs are present, epinephrine must be given promptly because it reverses the life-threatening effects of anaphylaxis—opening the airways, increasing blood pressure, and improving perfusion. Administer the epinephrine intramuscularly (typically in the thigh) without delay, and immediately call for help. While you treat, ensure the patient has high-flow oxygen, establish IV access, and monitor vitals closely; be prepared to provide additional fluids or airway support if needed. Antihistamines and corticosteroids may be used later, but they do not replace epinephrine as the first-line life-saving intervention. Continuing penicillin or selecting another antibiotic without evaluating the allergy during an acute reaction could worsen the situation, so the focus is on stopping exposure and reversing the anaphylactic process.