30/05/2025
Penicillin Allergy labelling in medical records is very common. up to 10% of the population are labelled as being allergic to Penicillin. That includes 2.7 million people in the UK. Research has shown that 95% of these Penicillin Allergy labels are incorrect when tested. Penicillin is a very useful and an effective low cost antibiotic and by needlessly avoiding it, patients are restricted in their infectious disease treatment options. This results it stronger non-penicillin antibiotics being used and rise in bacterial antibiotic resistance. Most Penicillin Allergy labels relate to childhood rashes and then a presumed penicillin allergy and life-long avoidance. Even if a childhood rash was caused by penicillin, 80% will develop tolerance within a decade. There is a strong need for “Penicillin De-labelling” clinics as advocated by the British Society for Allergy and Clinical Immunology (BSACI) and the American Medical Association. These clinics would involve a thorough Penicillin Allergy medical history, followed by skin prick and intradermal testing to the penicillin allergens and then a supervised challenge test to penicillin (most usually oral amoxicillin) called a Drug Provocation Challenge (DPC). If the penicillin challenge shows no reactivity, the “Penicillin Allergy” label on medical notes can be removed.
Reference: Evaluation of Management Penicillin Allergy ; Shenoy E. Jama 2019 (188-199)
