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Challenges of delabelling penicillin allergy
  1. Michael Wilcock,
  2. Neil Powell
  1. Pharmacy Department, Royal Cornwall Hospitals NHS Trust, Truro, UK
  1. Correspondence to Mr Neil Powell; neil.powell2{at}

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The global focus on antimicrobial stewardship (AMS) and reducing inappropriate use of antimicrobials has resulted in interventions such as prescribing guidelines, monitoring antibiotic usage and incentives to improve prescribing. It is also recognised that efforts to improve AMS need to tackle social and structural contributing factors. One such factor is the high number of patients that are reported to be allergic to penicillin.

The problem with penicillin allergy labels

Estimates suggest that in the UK, 6% of adults have a label of penicillin allergy in their general medical records, while the proportion of hospital inpatients with a label of penicillin allergy in their hospital records may be even higher.1 However, a systematic review and meta-analysis has suggested that more than 95% of these labels are found to be incorrect following comprehensive allergy testing.2 Penicillin allergy labels increase the risk of serious hospital-acquired infections1 3 are associated with a higher risk of surgical site infections,4 lengthened hospital stay5 and greater use of more expensive antibiotics such as carbapenems6 and fluoroquinolones. …

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  • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

  • Provenance and peer review Commissioned; externally peer reviewed.