Further Evidence for Using the PEN-FAST Penicillin Allergy Decision Tool

More than 90% of patients who are labeled as penicillin allergic have no true allergy. Avoiding penicillins in these patients often leads to adverse outcomes, including nosocomial and perioperative infections and more-expensive and longer hospital stays. The previously described PEN-FAST decision tool is a simple and safe way to remove penicillin allergy labels without skin testing (NEJM JW Gen Med Apr 15 2020 and JAMA Intern Med 2020; 180:745). PEN-FAST scores allergy risk as follows:

• An allergy event ≤5 years ago (2 points)

• Anaphylaxis/angioedema or severe cutaneous adverse reaction (2 points)

• Treatment required for allergy episode (1 point)

To further validate PEN-FAST, researchers conducted a 2-year retrospective review of 120 patients from…