Does this child really have a penicillin allergy?

Penicillins, the most prescribed paediatric medications worldwide, are also the most commonly reported cause of medication allergy, although this is rarely confirmed. An oral penicillin challenge is considered the gold standard in assessing children with suspected allergy but is seldom performed due to lack of appropriately trained staff and insufficient facilities. We introduced a standardised nurse-led protocol to evaluate children with suspected penicillin allergy fulfilling low risk criteria. In total, 40 children participated, including 22 girls and 18 boys, of which 38 met study criteria. There were 36 (95%) negative challenges completed, allowing these children to be safely prescribed oral penicillin in the future. There were 2 (5%) positive challenges developing similar signs to their initial reaction. This standardised protocol appears to be safe for use and efficient in the evaluation of low risk children with suspected penicillin allergy.