New guideline may help improve testing for penicillin allergies

by Wiley

Chemical structure of Penicillin G. The sulfur and nitrogen of the five-membered thiazolidine ring are shown in yellow and blue respectively. The image shows that the thiazolidine ring and fused four-membered β-lactam are not in the same plane. Credit: Public Domain

A new guideline published in Clinical & Experimental Allergy will help clinicians evaluate and test patients for potential penicillin allergies.

The guideline was developed by the Standards of Care Committee of the British Society for Allergy and Clinical Immunology (BSACI) along with a committee of experts and key stakeholders.

The group’s recommendations include a checklist to identify patients at low risk of allergy and a framework for conducting drug provocation testing—or exposure to penicillin in a controlled environment—by non-allergists. There are separate recommendations for adults and children within the guideline. 

“The intended users are non-allergists with an interest in clarifying the penicillin allergy status of their patients. The guideline details appropriate patient selection, risk stratification, minimum safety standards, conduct of a drug provocation test, and the degree of oversight required from allergy or immunology specialists,” the authors wrote. “The guideline will be reviewed 5 years from original publication date.”