Penicillin Allergy Delabeling

As per CDC, approximately 10% of all US patients report having an allergic reaction to a penicillin class antibiotic in their past. When evaluated, however, fewer than 1% of the population are found to be truly allergic.

This page contains resources to support health care professionals with their penicillin allergy delabeling efforts.

Webinar Mini-Series for Health Care Professionals

• Session 1: Introduction to Penicillin Allergy Delabeling
  • Presented by Jessica Zering, PharmD - Antimicrobial Stewardship Pharmacist at WA DOH
  • Dr. Zering gives a brief overview of this topic and discusses why it is important
  • Slides of presentation (PDF)
• Session 2: Penicillin Allergy Delabeling at Seattle Children's Hospital
  • Presented by Victoria Konold, MD – Assistant Professor, Pediatric Infectious Diseases at Seattle Children's Hospital/University of Washington
  • Dr. Konold describes her team’s approach to penicillin allergy delabeling in the hospital setting.
  • Slides of presentation (PDF)
• Session 3: Penicillin Allergy Labels – Pathways Forward in Patient Care
  • Presented by Paul Pottinger, MD, and Rupali Jain, PharmD – University of Washington
  • Dr. Pottinger and Dr. Jain give a brief overview of penicillin allergy labels, describe the University of Washington's current initiatives (decision tools and pre-op), and share a vision for primary care
  • Slides of presentation (PDF)
• Session 4: Antibiotic Allergy Delabeling Journal Club
  • Presented by Erica Stohs, MD, MPH – Lead Antimicrobial Stewardship Policy Advisor at WA DOH
  • Dr. Stohs reviews the PALACE study and a beta-lactam allergy delabeling intervention performed in a community hospital.
  • Slides of presentation (PDF)

General Educational Resources for Patients

These educational resources are intended to be given to eligible patients by health care providers.

• Pediatric Penicillin Allergy Education (PDF) | In Spanish (PDF)
  Explains why it is important to have penicillin allergies assessed in pediatrics
• Do You Really Have a Penicillin Allergy Patient Education Poster (PDF)
  Contains QR codes that can be scanned to access further education on this topic in both English and Spanish. Intended to be posted up in waiting areas or in other patient care areas.
• Is It Really a Penicillin Allergy Handout (PDF) | In Spanish (PDF)
  Provides education to patients on this topic and explains why it is important to have penicillin allergies assessed
• Penicillin Allergy Testing Educational Handout (PDF) | In Spanish (PDF)
  Educates the patient on what to expect with penicillin allergy testing methods.
• Project Firstline, Episode 16.2: Penicillin Allergies
  Provides an 8-minute overview of this topic in a podcast format. The intended audience is clinicians and patients.

Specialized Educational Resources for Patients

These educational resources are intended to be given to eligible patients by health care providers participating in an established penicillin allergy desensitization program.

Facts About Penicillin Allergy Desensitization (PDF) | In Spanish (PDF)

• Desensitization is intended for patients who have a moderate to high risk of severe allergy needing urgent treatment with penicillins (e.g., treatment of syphilis with a confirmed penicillin allergy).
• Desensitization and de-labeling are separate processes. See General Education Resources for patient education for penicillin allergy de-labeling.

Implementation Guidance

• BC Provincial Antimicrobial Clinical Expert Group’s Beta-Lactam Allergy Delabeling Guideline and Toolkit
  Contains resources and guidance to assist facilities with creating a new penicillin allergy delabeling program, and a beta-lactam cross-reactivity chart on Page 36
• American Academy of Allergy, Asthma, and Immunology (AAAI) short videos:
  • How To Conduct an Inpatient Oral Amoxicillin Challenge
  • Implementing Amoxicillin Challenges in Your Pediatric Office
  • How to Conduct an Oral Amoxicillin Challenge in Your Office
  • Implementing Amoxicillin Challenges in the Adult Inpatient Setting

Clinical Guidance

• AAAI’s Drug Allergy Guideline
  Provides guidance for penicillin and beta-lactam allergy delabeling efforts
• CDC’s Is It Really a Penicillin Allergy?
  Contains education and questions to ask of a patient to evaluate a penicillin allergy

Assessment Tools

• University of WA’s Penicillin Allergy Assessment Tool
  Provides clinical decision support to assist with assessing & clarifying penicillin allergies
• PEN-FAST – Penicillin Allergy Risk Tool
  Enables point-of-care risk assessment of patient-reported penicillin allergies

Education

Healthcare Providers

• WA DOH’s Penicillin Allergy Delabeling Newsletter Article
  A one-pager that contains statistics showing the importance of de-labeling, plus links to resources to assist facilities with implementation
• ACAAI’s Coding for Penicillin Allergy Testing – Everything You Need to Know
  Contains information on billing codes for drug allergy testing
• AAAI’s How to Identity Patients at Low Risk of Having a Penicillin Allergy

Questions & Feedback

ams@doh.wa.gov