Does the PEN-FAST Score Hold Up for Older or Immunocompromised Patients?

The PEN-FAST risk stratification tool, first published in 2020, allows us to safely delabel penicillin allergy in patients who report this allergy or have it listed in their records but who do not actually have penicillin allergy. PEN-FAST uses 4 simple criteria, without the need for skin testing. A score ≤2 carries <5% risk for allergic reaction.

• Allergy event occurred Five or fewer years ago (2 points)

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

• Treatment required for allergy episode (1 point)

Now, researchers investigated its use in patients older than 60, immunocompromised patients, and patients who had delayed reactions to penicillin.