Hospitalist-driven penicillin allergy delabeling at a quaternary care academic medical center.

Moudgal, Anita N; Ward, Tara; Chandnani, Neal; Grimm, Eric; Huang, Misha; Scarpato, Sarah; Spencer, Sandra; Tchou, Michael J et al. · J Hosp Med · 2026

other · Level V

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Abstract

A penicillin allergy label is not benign and significantly impacts patient care. Penicillin allergy delabeling can be conducted in an efficient, cost-effective, and safe manner by proceeding directly to oral challenge. Through a quality improvement initiative, we developed and implemented a protocol for hospitalist clinicians to delabel penicillin allergies among low-risk hospitalized patients. Risk stratification was determined by PEN-FAST, a validated screening tool. The primary outcome was the total number of patients that underwent delabeling within 1 year. We exceeded our goal of delabeling more than 5% of patients in 1 year with no major adverse events.