Direct Amoxicillin Challenges for Penicillin Allergy Through Pediatric Primary Care Group Visits: A Pilot Study

Timothy G Chow; Candice Mercadel; Kristin S Alvarez; Madeline Kellam; David A Khan; Cesar Termulo

doi:10.1093/ofid/ofaf236

Direct Amoxicillin Challenges for Penicillin Allergy Through Pediatric Primary Care Group Visits: A Pilot Study

Open Forum Infect Dis. 2025 Apr 24;12(5):ofaf236. doi: 10.1093/ofid/ofaf236. eCollection 2025 May.

Authors

Timothy G Chow¹, Candice Mercadel², Kristin S Alvarez², Madeline Kellam³, David A Khan¹, Cesar Termulo⁴

Affiliations

¹ Division of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
² Center of Innovation and Value at Parkland, Parkland Health, Dallas, Texas, USA.
³ Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁴ Population Health, Parkland Health, Dallas, Texas, USA.

Abstract

Novel strategies are needed to expand equitable access to penicillin allergy testing. We performed a pilot study of penicillin allergy testing through direct challenges performed at pediatric primary care group office visits. Ninety-five percent of subjects were delabeled with no severe reactions noted, providing conceptual basis for further implementation studies.

Keywords: delabeling; drug challenge; infectious disease; penicillin allergy; primary care.