Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Aug 6;7(3):71.
doi: 10.3390/antibiotics7030071.

Patient and Prescriber Views of Penicillin Allergy Testing and Subsequent Antibiotic Use: A Rapid Review

Affiliations
Review

Patient and Prescriber Views of Penicillin Allergy Testing and Subsequent Antibiotic Use: A Rapid Review

Marta Wanat et al. Antibiotics (Basel). .

Abstract

About 10% of U.K. patients believe that they are allergic to penicillin and have a "penicillin allergy label" in their primary care health record. However, around 90% of these patients may be mislabelled. Removing incorrect penicillin allergy labels can help to reduce unnecessary broad-spectrum antibiotic use. A rapid review was undertaken of papers exploring patient and/or clinician views and experiences of penicillin allergy testing (PAT) services and the influences on antibiotic prescribing behaviour in the context of penicillin allergy. We reviewed English-language publications published up to November 2017. Limited evidence on patients' experiences of PAT highlighted advantages to testing as well as a number of concerns. Clinicians reported uncertainty about referral criteria for PAT. Following PAT and a negative result, a number of clinicians and patients remained reluctant to prescribe and consume penicillins. This appeared to reflect a lack of confidence in the test result and fear of subsequent reactions to penicillins. The findings suggest lack of awareness and knowledge of PAT services by both clinicians and patients. In order to ensure correct penicillin allergy diagnosis, clinicians and patients need to be supported to use PAT services and equipped with the skills to use penicillins appropriately following a negative allergy test result.

Keywords: antibiotic resistance; antibiotic stewardship; penicillin allergy; prescribing.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram showing the identification of papers from database searches.

References

    1. National Institute for Health and Care Excellence . Drug Allergy: Diagnosis and Management of Drug Allergy in Adults, Children and Young People. NICE; London, UK: 2014. - PubMed
    1. Minh H.-B.C., Bousquet P.J., Fontaine C., Kvedariene V., Demoly P. Systemic reactions during skin tests with β-lactams: A risk factor analysis. J. Allergy Clin. Immunol. 2006;117:466–468. doi: 10.1016/j.jaci.2005.10.020. - DOI - PubMed
    1. Charneski L., Deshpande G., Smith S.W. Impact of an antimicrobial allergy label in the medical record on clinical outcomes in hospitalized patients. Pharmacotherapy. 2011;31:742–747. doi: 10.1592/phco.31.8.742. - DOI - PubMed
    1. Mistry A., Arumugakani G., Toolan J., Ford K., Sandoe J., Wood P., Savic S. Does de-labelling penicillin allergy lead to a respective change in primary care records?; Proceedings of the British Society for Allergy and Clinical Immunology Annual Meeting; Telford International Centre, Telford, UK. 4–6 September 2015.
    1. Salkind A.R., Cuddy P.G., Foxworth J.W. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy. JAMA. 2001;285:2498–2505. doi: 10.1001/jama.285.19.2498. - DOI - PubMed

LinkOut - more resources