Clinical progress note: De-labeling penicillin allergies.

About 15% of hospitalized adults report a penicillin allergy. Of these patients, approximately 90% tolerate penicillin when re-challenged, potentially due to misattribution of nonallergic rash as hypersensitivity or outgrowing the index reaction. Patients with penicillin allergy labels are more likely to receive less effective therapy, develop antibiotic resistance, incur higher healthcare costs, and have poorer outcomes. Although cephalosporins are recommended for most patients with a reported or confirmed penicillin allergy, de-labeling and removing penicillin allergies represent an impactful antimicrobial stewardship activity. A recently developed scoring tool (PEN-FAST) identifies those at low risk for a recurrent reaction and is less cumbersome than traditional testing methods.