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The PEN-FAST scoring system* is a valuable tool for identifying adults who are at low risk for true penicillin allergies (NEJM JW Gen Med Apr 15 2020 and JAMA Intern Med 2020; 180:745). Patients with scores of 0 to 2 have low risk (<5%) for a penicillin allergy and safely can skip penicillin skin testing and proceed to a direct oral challenge. Now, researchers examined PEN-FAST's use in children and adolescents.
This retrospective study from Turkey included 700 children and adolescents (age range, 6–18 years) with suspected penicillin allergy who were evaluated in an allergy clinic using a standardized assessment with selective skin testing and observed oral challenge. Penicillin allergy was confirmed in 64 patients (9%), all of whom had PEN…