![]() 5 There are multiple strategies for penicillin allergy de-labeling that are primarily based on the history of the reaction and patient comorbidities. ![]() After formal allergy evaluation, including skin testing, up to 99% of patients with reported PCN allergy are found not to be allergic. Reported allergies to PCN, however, do not equate with true IgE-mediated allergy. 6 Strategies for Penicillin Allergy De-labeling 6 In fact, in the survey responses only 37% would prescribe ceftriaxone, 46% would prescribe cefepime, and 66% would prescribe meropenem, even though all of these agents are safe in most penicillin-allergic patients. If you find that deciding which antibiotics can be safely prescribed in the setting of a patient reported penicillin allergy is challenging, you are not alone! A survey of 521 providers at Mass General highlighted that 42% of providers reported no prior education in antibiotic drug allergies, and only 68% reported feeling prepared to prescribe antibiotics for the penicillin-allergic patient. 1 Furthermore, many patients with reported PCN allergy are not receiving drugs, such as later-generation cephalosporins and carbapenems, that are safely tolerated despite a PCN allergy. Patients with reported PCN allergies often receive more costly and broad-spectrum antibiotics than patients without these reported allergies. 1 Specifically, penicillin (PCN) allergy is reported in up to 10% of the general population and up to 16% of inpatients. Approximately half of all patients admitted to the hospital receive antibiotics, and 25% of inpatients who require antibiotics report at least one antimicrobial drug allergy. Patient reported antibiotic allergies present clinicians with challenging decisions at the point of prescribing. Addressing Reported Penicillin Allergy – A 2022 Practice Parameter Update Antibiotic Awareness Week 2022 ![]()
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