Stevenson et al reported a protocol for evaluating a patient for penicillin allergy in the outpatient setting. The authors are from multiple institutions in Australia.
Patient selection: penicillin allergy recorded in medical record
Categories:
(1) re-exposure contraindicated (very high risk)
(2) high risk
(3) low risk
(4) no risk
Risk
Criteria
contraindicated
possible or definite systemic cutaneous adverse reaction (SJS-TENS, DRESS, AGEP)
high risk
one of the following:
(1) penicillin rash within past year
(2) angioedema
(3) systemic symptoms
(4) unknown history for drug reaction
(5) high risk comorbidities that may make resuscitation difficult
low risk
benign rash (without mucosal or systemic symptoms) more than 1 year ago
