Penicillin allergy de-labelling

SAPG has completed an initiative to develop and test a risk-based process to remove penicillin allergy labels from patients with unverified allergy. This involved an audit of current practice and evidence review to inform a risk-based algorithm.

The algorithm and supporting communication tools were piloted in hospital settings in five regional health boards across Scotland to assess practical use and acceptability. Local governance processes were followed and the process was tested in over 100 consenting patients whose allergy history suggested low risk for having an actual Type 1 or Type 4 hypersensitivity. Feedback from clinicians and patients was positive.

This risk-based process appears to be safe and feasible for use by non-allergy specialists to remove penicillin allergy labels from patients with unverified allergic reactions. This has positive implications for patients in terms of options for future antibiotic treatment.

Resources for clinicians

Protocol for implementation of penicillin allergy de-labelling in adult patients in acute hospitals

Patient risk allergy algorithm

Management of patients experiencing allergic symptoms

Frequently asked questions to support use of the penicillin allergy de-labelling algorithm and oral challenge test

GP de-labelling letter (positive)

GP de-labelling letter (negative)

Allergy card front

Allergy card back

Resources for patients

Pre test information for patients

Patient permission form to be signed if proceeding with test

Patient post test result (positive)

Patient post test results (negative)

We have published two articles on this work: