Aim Penicillin allergy (Pen A) is the most commonly reported drug allergy worldwide, with approximately 10% of the population carrying this label. However, over 90% of these labels are inaccurate. A Pen A label is associated with increased morbidity, mortality, antibiotic resistance and healthcare costs. Pen A delabelling has become a clinical and public health priority, with recent focus on tools like PenFAST for risk stratification in nonspecialist settings. The aim of this work is to determine the prevalence of Pen A among adult inpatients at a large UK teaching hospital and to stratify their risk of allergic reactions using the validated PenFAST tool. Materials and methods A cross‐sectional point prevalence survey was conducted over two days in June 2024 across two hospital sites of the University Hospital of North Midlands. All adult inpatients (excluding maternity wards) were screened for Pen A using demographic data and drug charts. Patients with a Pen A label were assessed using PenFAST. Statistical analysis was performed to determine prevalence and identify risk categories. Results Among 1136 inpatients, 16.3% ( n = 185, 95% CI: 14.2–18.5) were labelled penicillin allergic. Older patients (> 65 years), women and those admitted to medical wards were more likely to carry the label. Pen A label increased the likelihood of diagnosis with other antibiotic allergies (RR: 3.56, 95% CI: 2.52–5.03). Risk stratification identified 55.6% ( n = 85) of patients as low risk (PenFAST ≤ 2), suggesting they could be safely delabelled by nonspecialists. Conclusion Pen A prevalence amongst adult inpatients was higher than expected in this study. A significant proportion of inpatients with Pen A are at low risk of true allergy and can potentially be delabelled by nonspecialists using validated clinical history–based tools.
Chan et al. (Thu,) studied this question.