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Keywords: delabeling; drug allergy; drug provocation test; penicillin allergy; penicillin allergy labels EN delabeling drug allergy drug provocation test penicillin allergy penicillin allergy labels 969 973 5 09/05/23 20230901 NES 230901 Key messages Correct penicillin allergy labels are crucial for patient safety and correct patient management. Twenty-nine patients with a disproved allergy still had an incorrect penicillin allergy label in the hospital EMR, and of those, 16 (55.1%) also had an incorrect penicillin allergy label in primary care. The primary aim of this study was to investigate the degree of match/mismatch between penicillin allergy labels in hospital and primary care EMR systems in patients who had undergone penicillin allergy investigation in a hospital allergy clinic. Among patients with a disproved allergy, 93 patients (21.4%) still had an incorrect penicillin allergy label in primary care (79 GP clinics). [Extracted from the article]

Many patients experience reactions during penicillin treatment. The diagnosis may be difficult and is mainly based on short-term tests. The European Network for Drug Allergy (ENDA) guidelines proposed for diagnosing penicillin allergy do not include long-term challenge. In this study a total of 405 patients were evaluated. The ENDA guidelines were extended, to include a 7-day oral treatment (p.0.7) with penicillin for all patients who were negative in the ENDA programme. Among the 405 patients; 85 had an immediate reaction to penicillin, and a further 13 reacted during p.o.7. Among the 307 patients with a negative outcome, 88 had a case history of reaction to other ß-lactam antibiotics and were subsequently tested with the culprit drug. Thirteen patients had a positive outcome: 3 on single-dose challenge and 10 during p.o.7. The extended penicillin diagnostic work-up was positive in 111 patients, 30.0% showed immediate reactions and 5.7% reacted during p.o.7. Approximately 20% of all patients with positive outcome during penicillin challenge are detected by adding p.o.7 with penicillin to the original ENDA guidelines. [ABSTRACT FROM AUTHOR]