Implementation of Nursing Protocols for Penicillin-allergy Assessment in an STI Clinic

Penicillin allergy assessment within STI clinics is critical for timely, safe, and effective syphilis treatment among marginalized populations who experience multiple barriers to care. It is also an important public health measure to support antibiotic stewardship in populations at high-risk for antibiotic use. This report describes a quality improvement project in an STI clinic which used nursing protocols for penicillin allergy assessment with a validated risk scoring tool (PEN-FAST) and direct oral amoxicillin challenge. In the first year of protocol implementation, just over 75% of patients with syphilis who reported penicillin allergy were treated safely with benzathine penicillin G.