Delabelling Penicillin Allergy: How do I do it?

Only one in 10 patients with reported penicillin allergy has true penicillin allergy. De-labelling penicillin allergy allows patients to receive desired antibiotic treatment, reduce use of less effective and costly alternatives, aids in antibiotic stewardship and impact positively on healthcare cost. The threshold to evaluate penicillin allergy is low as beta-lactam antibiotics are widely used and remain effective anti-microbial agents. Classifying the index reaction into immediate or delayed and performing risk stratification prior to formal evaluation of the allergy are important. Relevant skin tests in penicillin allergy de-labelling and cross reactivity of penicillin with other beta-lactams will also be discussed.