Non-Allergist Delabeling - Should penicillin allergy delabeling only be performed by allergists?

Timothy G Chow; Deanna L McDanel; Nicholas A Turner; Ana Maria Copaescu

doi:10.1016/j.jaip.2024.11.028

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Non-Allergist Delabeling - Should penicillin allergy delabeling only be performed by allergists?

Journal article

Peer reviewed

Non-Allergist Delabeling - Should penicillin allergy delabeling only be performed by allergists?

Timothy G Chow, Deanna L McDanel, Nicholas A Turner and Ana Maria Copaescu

The journal of allergy and clinical immunology in practice (Cambridge, MA), Vol.13(5), pp.1011-1017.e2

05/2025

DOI: 10.1016/j.jaip.2024.11.028

PMID: 39725315

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Abstract

Penicillin allergy labels (PAL) are common but rarely correspond with a patient's likelihood to tolerate penicillin. This results in unnecessary penicillin avoidance in many patients, driving numerous negative health outcomes. Evaluation strategies for PAL are driven by risk stratification and include a spectrum of modalities such as delabeling without any testing, direct oral challenge, and skin testing followed by challenge testing. Historically, PAL delabeling has primarily been the domain of the allergist, but this has resulted in significant limitations in access to testing for many patients globally and in the United States. Novel strategies to increase access to penicillin allergy evaluations are urgently needed, and non-allergist delabeling has been proposed as one strategy to help address this. Using a pro/con format, we review the evidence for non-allergist PAL delabeling in children and adults, focusing on direct challenge testing and highlighting considerations to guide non-allergist implementation of penicillin allergy evaluations.

primary care

penicillin allergy

drug challenge

infectious disease

delabeling

testing

Details

Title: Subtitle: Non-Allergist Delabeling - Should penicillin allergy delabeling only be performed by allergists?
Creators: Timothy G Chow - The University of Texas Southwestern Medical Center
Deanna L McDanel - University of Iowa
Nicholas A Turner - Duke University
Ana Maria Copaescu - McGill University Health Centre
Resource Type: Journal article
Publication Details: The journal of allergy and clinical immunology in practice (Cambridge, MA), Vol.13(5), pp.1011-1017.e2
DOI: 10.1016/j.jaip.2024.11.028
PMID: 39725315
NLM abbreviation: J Allergy Clin Immunol Pract
ISSN: 2213-2201
eISSN: 2213-2201
Language: English
Electronic publication date: 12/24/2024
Date published: 05/2025
Academic Unit: Pharmacy Practice and Science; Internal Medicine
Record Identifier: 9984759115302771

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