Long-Term Follow-Up After Penicillin Allergy Delabeling in Ambulatory Patients

Towards a more precise diagnosis of hypersensitivity to beta‐lactams — an EAACI position paper

“…Other groups believe that a too short exposure to BL (in terms of days) can be responsible for false‐negative DPT, this being the rationale for performing DPT with a duration of 2‐5 days or even of 7‐10 days to confirm or rule out a delayed hypersensitivity.…”

“…According to most of the authors of this paper, 1‐day DPT should be preferred to prolonged DPT because it is sufficient to establish a firm diagnosis. Considering the literature data, however, prolonged DPT might be done if it is necessary to convince patients, or their parents and/or physicians, that treatments with the BL concerned will be tolerated in real‐life conditions. In patients who undergo prolonged DPT, the wash‐out period and duration of these DPT could be chosen according to the chronology of the index reaction.…”

Penicillin Allergy Assessment and Skin Testing in the Outpatient Setting

“…A follow-up study of 784 allergy clinic patients who had PST and a 5-day oral amoxicillin challenge were reviewed for subsequent penicillin use after PST. Of the 163 patients who did not receive a penicillin during the follow-up period, 45 (27%) refused to use a penicillin because they believed that it would not be safe or did not fully understand the PST results [47]. A similar study was performed at a tertiary academic outpatient practice over a 3-year period [48].…”

The Low Risks and High Rewards of Penicillin Allergy Delabeling: An Algorithm to Expedite the Evaluation

“…In 1 study of longterm follow-up after penicillin delabeling, 335 of 639 patients (51%) still had the penicillin allergy listed in their chart after a successful challenge. 15 This lack of change may occur because patients re-endorse the allergy or do not understand the significance of challenge procedure. Medical staff may want to re-enter the allergy just to be safe.…”