Vnitr Lek 2025, 71(6):359-363 | DOI: 10.36290/vnl.2025.068

Penicillin allergy delabeling - the path to effective antibiotic therapy

Lenka Sedláčková¹, Tereza Rudová²

¹ GENNET, s. r. o., Alergologie a klinická imunologie, Praha

² Klinika infekčních nemocí 2. LF UK a FNB, Praha

Betalactam allergy, especially the most common allergy to penicillin, is one of the most common drug allergies. Ten percent of patients claim to have it, although in 90% of them it is ruled out after a thorough allergy testing and they tolerate penicillin. The use of alternative antibiotics in these patients may be associated with lower efficacy, more side effects, higher risk of multidrug-resistant bacterial infections and longer hospital stays. Comprehensive allergy testing to rule out allergy may not always be available. However, strategies are emerging in antimicrobial stewardship programs to quickly and safely screen for penicillin tolerance without an allergist on the ward. This article presents the current approach and perspectives on penicillin allergy delabeling, including risk stratification using the PEN-FAST score tool and direct provocation testing for low-risk patients in clinical practice.

Keywords: allergy, penicillin, delabeling, PEN-FAST.

Accepted: September 21, 2025; Published: October 2, 2025  Show citation