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Direct Oral Challenge for Penicillin Allergy: A Hospital Implementation Evaluation Via the International Network of

Elise A Mitri1,2,3, Sara Vogrin1,2, Camille Paynter4

  • 1Centre for Antibiotic Allergy and Research, Department of Infectious Diseases and Immunology, Austin Health, Heidelberg, Victoria, Australia.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 1, 2026
PubMed

Keywords:
antimicrobial stewardshipaudit and feedbackimplementationoral challengepenicillin allergy

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Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin,...
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