Penicillin Allergy Evaluation Should Be Performed Proactively in Patients With a Penicillin Allergy Label

Abstract

Penicillin allergy is the most common drug allergy in the US population. A penicillin allergy label is associated with poor patient outcomes including increased hospital length of stay, increased perioperative infections, and overall increased mortality. A penicillin allergy evaluation accurately identifies approximately 9 of 10 patients who, despite reporting a history of penicillin allergy, can receive penicillins safely. Penicillin allergy evaluations should be offered proactively to healthy patients during routine visits, including children and pregnant women, in advance of antibiotic need.

Keywords: Anaphylaxis; Antibiotic stewardship; Direct oral challenge; Drug allergy; Penicillin allergy; Penicillin skin testing; β-Lactam allergy.