Itchy rash on day three of an antibiotic
PEBC OSCE practice station
Counselling & explanation · 2 min to read · 7 min to perform
Try a real conversation · PEBC OSCEAI practice
Assess what has happened, advise her and explain what she should do next.
Elena PetrovaHi, I started this antibiotic three days ago and now I have this itchy rash on my chest and arms. Is that normal?
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You are a pharmacist in a community pharmacy. Ms Elena Petrova, aged 34, comes to the counter holding a bottle of amoxicillin that was started three days ago for a sinus infection. She says she has developed a rash. She is alone. Assess what has happened, advise her and explain what she should do next. The assessor will not take part in the conversation.
What this station tests
- Screen for severe reaction first, then advise stopping the suspect drug.
- Observe the patient: breathing and visible swelling are part of the assessment.
- Hives with lip tightness need urgent assessment today: help arrange it and a different antibiotic.
- Document the reaction and consider a voluntary report to Health Canada.
- A drug allergy label should be investigated later, not assumed.
Sources for the clinical content
- Health Canada: Canada Vigilance Program
- Penicillin allergy de-labelling program study (Allergy, Asthma & Clinical Immunology, 2024)
- NAPRA: Model Standards of Practice for Pharmacists and Pharmacy Technicians in Canada
An original practice scenario with invented patients. Not an exam question.