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About 10% of the U.S. population has received a penicillin allergy diagnosis, but most such patients are not truly allergic. As a method to “delabel” these patients, penicillin skin testing is safe and highly effective, but it is not always available due to lack of time, resources, and expertise.
Researchers in New York State examined whether skin testing is always needed to refute penicillin allergy. They randomized 159 patients (age, ≥5 years) with reported penicillin allergy to skin testing or oral drug challenge. All patients had experienced only mild cutaneous reactions that occurred more than 10 years ago (or more than 1 year ago in children). The oral challenge consisted of 1/10 of a full dose of penicillin, followed by the remainder …