Penicillin allergy delabeling: Opportunities for implementation and dissemination

Area of Science:

• Clinical Medicine
• Allergy and Immunology
• Infectious Diseases

Background:

• Unconfirmed penicillin allergy labels pose risks, including increased healthcare costs and the spread of antibiotic-resistant bacteria.
• Accurate penicillin allergy assessment is crucial for patient safety and effective antibiotic stewardship.
• Professional and public health organizations advocate for proactive penicillin allergy evaluations to remove inaccurate labels.

Purpose of the Study:

• To review current practices for penicillin allergy delabeling.
• To discuss opportunities for expanding penicillin allergy delabeling services.
• To highlight the role of delabeling in quality improvement initiatives.

Main Methods:

• Penicillin allergy evaluation typically involves a detailed allergy history, potentially followed by skin testing and drug challenge.
• Current delabeling is primarily conducted by allergy specialists in outpatient settings.
• Expansion to other specialists like internists, pediatricians, and pharmacists is being explored.

Main Results:

• Penicillin allergy delabeling is feasible and can be expanded to various medical professionals.
• Limited access to penicillin allergy evaluation services is a significant barrier.
• Successful delabeling can improve antibiotic selection and reduce healthcare costs.

Conclusions:

• Expanding penicillin allergy delabeling efforts is essential to mitigate the negative consequences of mislabeled allergies.
• Interdisciplinary collaboration and investment are needed to increase access to delabeling services.
• Penicillin allergy delabeling represents a valuable quality improvement strategy.