Strategies to identify and prevent penicillin allergy mislabeling and appropriately de-label patients

De-labeling requires a systems approach. Given the mismatch between the large number of patients labeled “penicillin allergic” and the few allergy specialists, referral alone is not enough to solve the problem of mislabeling. Targeting specific populations for testing, such as patients presenting to an inner-city sexually transmitted infection clinic¹⁹ or preoperative patients, as is done at the Mayo Clinic,⁹ has been successful. Skin testing in an inpatient setting has also been shown to be safe and effective,¹³ allowing for protocol-driven testing under the supervision of trained pharmacists (and others), to relieve the burden on allergy specialists.⁹

CORRESPONDENCE
Andrew Lutzkanin, MD, 500 University Drive, PO Box 850, Hershey, PA 17033; alutzkanin@pennstatehealth.psu.edu