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Penicillin Allergy Delabeling - The Benefits of Addressing Penicillin Allergy and How to Select and Delabel Suitable Patients

Toolkit and On-demand Webinars

CME available

Shazia Lutfeali, MD
Marcia Glick, Pharm.D.
Rekha Murthy, M.D

June 23, 2025

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Penicillin allergy wrist band

Penicillin allergy is the most commonly reported drug allergy. Approximately 10% of patients self-report an allergy to penicillin but over 90% of these individuals are not truly allergic. This discrepancy is largely due to two factors: (1) true penicillin allergies often resolve over time, typically within 5–10 years, and (2) non-allergic side effects are frequently misinterpreted and mislabeled as allergic reactions.

This widespread mislabeling has significant clinical consequences. Patients labeled as penicillin-allergic are often prescribed alternative antibiotics, which are associated with higher rates of treatment failure, adverse drug events, and the development of antibiotic-resistant bacteria.

Recognizing this as a major public health concern, the Centers for Disease Control and Prevention (CDC), American Academy of Allergy, Asthma & Immunology (AAAAI), Society for Healthcare Epidemiology of America (SHEA), and Infectious Diseases Society of America (ISDA) strongly advocate for the implementation of penicillin allergy delabeling protocols. These programs do not require an allergist and can be safely performed in most healthcare settings. A thorough allergy history, followed by an oral amoxicillin challenge, is often sufficient to rule out a true allergy.

There are not enough allergists available to perform penicillin allergy delabeling. Therefore, it is important that primary care providers and healthcare institutions be informed and take a proactive role in delabeling patients. Doing so improves antibiotic stewardship, enhances patient safety, and supports better health outcomes.

The on-demand webinars below are designed for healthcare providers in hospitals and primary care settings including physicians, advanced practitioners, pharmacists, and nurses as well as antibiotic stewardship specialists and infection preventionists.

 

CME Webinar Part 1: How to Delabel Patients

This webinar includes an update on recent guidelines for addressing penicillin allergy; the benefits of penicillin allergy delabeling; and identifying appropriate candidates for oral amoxicillin challenge. Participants should become familiar with safe and effective ways to delabel patients identified as penicillin allergic. View Part I.

 

CME Webinar Part 2: Case Based Discussion

This case-based discussion includes patient selection for penicillin allergy delabeling, how to perform an amoxicillin challenge and manage adverse events, provide patient counseling on penicillin allergy delabeling and ways to implement a penicillin allergy delabeling program. View Part II.

 

Additional information (i.e., toolkit, implementation guide, patient education) is available on the Los Angeles County Department of Public Health Antimicrobial Stewardship Program homepage.

Penicillin allergy delabeling toolkit for hospitals
Penicillin Allergy Delabeling: Implementation Guidance and Resources
Antibiotic Stewardship Homepage.

 

  Continuing Medical Education
 

Continuing Medical Education

Visit the CME webpage to view live and on-demand DPH CME webinars and articles.

 

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Author Information:

Shazia Lutfeali, MD
Allergy and Immunology Assistant Professor,
Departments of Medicine and Pediatrics,
Cedars-Sinai Medical Center.


Marcia Glick, Pharm D
Rekha Murthy, MD
Co-Leads - Antibiotic Stewardship Program,
Healthcare Outreach Unit,

Acute Communicable Disease Control Program,
County of Los Angeles 
Department of Public Health


 

Stewardship@ph.lacounty.gov

www.publichealth.lacounty.gov/acd


Rx for Prevention, 2025
Published: June 23, 2025