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Ninety percent of patients who report penicillin allergy can tolerate the drug, and it has been shown that using alternative non–β-lactam antibiotics in these patients leads to higher healthcare costs and adverse events. Institutions are trying to delabel patients, but there are too few allergists to evaluate them all. Recent studies have confirmed the safety of clinician-administered oral challenges in low-risk patients, without prior skin testing (NEJM JW Gen Med Aug 15 2017 and J Allergy Clin Immunol Pract 2017; 5:669), but the definition of “low-risk patient” is unclear.
To better define this group, researchers in Australia retrospectively analyzed the records of 447 patients who had undergone skin testing, oral challenge, or both to con…