[Successful removal of penicillin allergy label in a tertiary hospital in Paraguay].

Abstract

Objective: To develop a treatment algorithm for patients with penicillin allergy.

Methods: Retrospective study, carried out in adult patients with penicillin allergy, who were in group 3 or 4 of the established classification, and attended the outpatient clinic of the Department of Pulmonology and Allergy of the Central Hospital of the Social Security Institute, between January 2021 and December 2022. Each patient underwent an amoxicillin provocation test, after obtaining informed consent.

Results: 60 patients were registered, who were able to remove the penicillin allergy label and whose medical history was corrected, with financial benefits for the patient and the health service of Paraguay.

Conclusions: Penicillin allergy labels can lead to irrational prescription of antibiotics, prolonged hospital stays, and increased need for consultation. Risk stratification, based on historical characteristics alone, is capable of safely identifying ideal patients for direct challenge testing. This study demonstrates the feasibility of the first penicillin delabeling program applicable in an outpatient setting, which can be performed even outside of hospital allergy services.