Rationale for de-labelling penicillin allergies

• 10% of hospital inpatients have a penicillin allergy label, but most of these are not truly allergic.
• On average, out of 100 patients labelled penicillin-allergic:
  • 90 are not allergic at all
  • 9 will have a mild-moderate reaction
  • 1 will have a severe allergy (Defined below)

 

Risks of being labelled penicillin allergic:

• Being labelled "penicillin-allergic" is associated with:
  • Treatment failure
  • Increased hospital length of stay
  • Side effects from the drug
  • Admission to intensive care
  • Death on intensive care
  • Surgical site infections
  • Healthcare-associated infection: Difficile, MRSA or VRE

Removing a penicillin allergy label will benefit the patient now and in the future, and contributes to antimicrobial stewardship.

 

Who can assess a penicillin allergy?

 

Definition of Severity

NB: Many patients who report an allergy actually have a non-allergy (intolerance or side effect) and can be safely de-labelled without further assessment.

For advice on which antibiotics you can prescribe for patients who remain penicillin-allergic, see 4. Antimicrobial Prescribing for Patients with Penicillin Allergy.

 

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