• Neil Powell, Shuayb Elkhalifa, Daniel Hearsey, Michael Wilcock, and Jonathan Sandoe.
• Pharmacy Department, Royal Cornwall Hospital Trust, Truro, UK. Electronic address: neil.powell2@nhs.net.
• Clin Med (Lond). 2024 Jul 1; 24 (4): 100225100225.

ObjectivesWe aimed to assess the appropriateness of penicillin allergy (PenA) assessment conducted by clinical teams and to review the safety of subsequent exposure of these patients to penicillin.MethodsOpportunistic, prospective observational study of usual clinical care, between 16 May 2023 and 14 August 2023, of inpatients with a PenA and requiring antibiotics, in a 750-bed hospital in England. To assess the appropriateness of management, PenA patients prescribed penicillins were grouped into risk categories using a validated antibiotic allergy assessment tool: eligible for de-label on history alone (direct de-label; DDL), eligible for direct oral challenge (DOC), high risk or unable to obtain history.ResultsOf the 123 patients admitted with a PenA (or sensitivity record) and exposed to a penicillin, data were collected for 50. Their PenA records were grouped follows: eligible for DDL 34 (68%), eligible for DOC 11 (22%), high risk 4 (8%) and unable to obtain history 1 (2%). In 14/50 (28%) patients there was no evidence of a current PenA assessment in the medical notes.ConclusionsUsing the allergy risk tool, most patients with PenA records were exposed to penicillin appropriately. However, patients meeting high-risk criteria were also exposed to penicillin when the tool excluded them. PenA assessment needs to be carried out with appropriate training and governance structures in place.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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