{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:07:47Z","timestamp":1788887267321,"version":"build-2803163510"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"DOI":"10.1007\/s11606-026-10793-w","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:17:45Z","timestamp":1788884265000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Penicillin Allergy Delabeling: Bridging the Evidence-Practice Gap in Antimicrobial Stewardship"],"prefix":"10.1007","author":[{"given":"Michelle","family":"Raja","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khush","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranav","family":"Krish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaki","family":"Azam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"issue":"10","key":"10793_CR1","doi-asserted-by":"publisher","first-page":"e51","DOI":"10.1093\/cid\/ciw118","volume":"62","author":"TF Barlam","year":"2016","unstructured":"Barlam TF, Cosgrove SE, Abbo LM, et al. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016;62(10):e51\u201377.","journal-title":"Clinical Infectious Diseases."},{"key":"10793_CR2","unstructured":"CDC. Clinical Features of Penicillin Allergy [Internet]. Antibiotic Prescribing and Use. 2024. Available from: https:\/\/www.cdc.gov\/antibiotic-use\/hcp\/clinical-signs\/index.html."},{"issue":"2","key":"10793_CR3","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1001\/jama.2018.19283","volume":"321","author":"ES Shenoy","year":"2019","unstructured":"Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and Management of Penicillin Allergy. JAMA. 2019;321(2):188.","journal-title":"JAMA."},{"issue":"6","key":"10793_CR4","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1016\/j.jaci.2022.08.028","volume":"150","author":"DA Khan","year":"2022","unstructured":"Khan DA, Banerji A, Blumenthal KG, et al. Drug allergy: A 2022 practice parameter update. Journal of Allergy and Clinical Immunology. 2022;150(6):1333\u201393.","journal-title":"Journal of Allergy and Clinical Immunology."},{"issue":"3","key":"10793_CR5","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1016\/j.jaci.2013.09.021","volume":"133","author":"E Macy","year":"2014","unstructured":"Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin \u201callergy\u201d in hospitalized patients: A cohort study. J Allergy Clin Immunol. 2014;133(3):790\u20136.","journal-title":"Journal of Allergy and Clinical Immunology."},{"key":"10793_CR6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k2400","volume":"27","author":"KG Blumenthal","year":"2018","unstructured":"Blumenthal KG, Lu N, Zhang Y, Li Y, Walensky RP, Choi HK. Risk of meticillin resistant Staphylococcus aureus and Clostridium difficile in patients with a documented penicillin allergy: population based matched cohort study. BMJ. 2018;k2400.","journal-title":"BMJ."},{"key":"10793_CR7","doi-asserted-by":"crossref","unstructured":"Trubiano JA, Vogrin S, Chua KYL, et al. Development and Validation of a Penicillin Allergy Clinical Decision Rule. JAMA Intern Med. 2020;180(5).","DOI":"10.1001\/jamainternmed.2020.0403"},{"issue":"9","key":"10793_CR8","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1001\/jamainternmed.2023.2986","volume":"183","author":"AM Copaescu","year":"2023","unstructured":"Copaescu AM, Vogrin S, James F, et al. Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy: The PALACE Randomized Clinical Trial. JAMA Intern Med. 2023;183(9):944-52.","journal-title":"JAMA Internal Medicine."},{"issue":"11","key":"10793_CR9","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1001\/jamainternmed.2024.4606","volume":"184","author":"KG Blumenthal","year":"2024","unstructured":"Blumenthal KG, Smith LR, Mann S, et al. Reaction Risk to Direct Penicillin Challenges. JAMA Intern Med. 2024;184(11):1374\u201383.","journal-title":"JAMA Internal Medicine."},{"key":"10793_CR10","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.ijid.2022.11.026","volume":"129","author":"N Powell","year":"2023","unstructured":"Powell N, Stephens J, Kohl D, et al. The effectiveness of interventions that support penicillin allergy assessment and delabeling of adult and pediatric patients by nonallergy specialists: a systematic review and meta-analysis. Int J Infect Dis. 2023;129:152\u2013161.","journal-title":"International journal of infectious diseases."},{"issue":"3","key":"10793_CR11","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1093\/cid\/ciaa653","volume":"73","author":"KYL Chua","year":"2020","unstructured":"Chua KYL, Vogrin S, Bury S, et al. The Penicillin Allergy Delabeling Program: A Multicenter Whole-of-Hospital Health Services Intervention and Comparative Effectiveness Study. Clin Infect Dis. 2020;73(3):487\u201396.","journal-title":"Clinical Infectious Diseases."},{"issue":"5","key":"10793_CR12","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.9820","volume":"4","author":"NA Turner","year":"2021","unstructured":"Turner NA, Wrenn R, Sarubbi C, et al. Evaluation of a Pharmacist-Led Penicillin Allergy Assessment Program and Allergy Delabeling in a Tertiary Care Hospital. JAMA Netw Open. 2021;4(5):e219820.","journal-title":"JAMA Network Open."},{"issue":"1","key":"10793_CR13","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s11882-025-01229-2","volume":"25","author":"MJ Molloy","year":"2025","unstructured":"Molloy MJ, Yan AP, Wilson AE, Beus J, Hess LM. Using the Electronic Health Record to Facilitate Drug Allergy Delabeling. Curr Allergy Asthma Rep. 2025;25(1):49.","journal-title":"Current Allergy and Asthma Reports."},{"key":"10793_CR14","doi-asserted-by":"crossref","unstructured":"Van De Sijpe G, Gilissen L, Wets D, et al. Evaluation of the Allergy Fact Checker, a clinical decision support system for non-invasive beta-lactam delabeling: a mixed-methods study. NPJ Digit Med. 2025;8(1).","DOI":"10.1038\/s41746-025-02030-1"},{"key":"10793_CR15","doi-asserted-by":"publisher","first-page":"106429","DOI":"10.1016\/j.jinf.2025.106429","volume":"1","author":"A Luintel","year":"2025","unstructured":"Luintel A, Healy J, Blank M, et al. The Global Prevalence of Reported Penicillin Allergy: A Systematic Review and Meta-Analysis. J Infect. 2025;106429\u20139.","journal-title":"Journal of Infection."},{"key":"10793_CR16","unstructured":"American Academy of Allergy, Asthma & Immunology. Penicillin Allergy Evaluation Should Be Performed Proactively in Patients with a Penicillin Allergy Label [Internet]. 2023 [cited 2026 Mar 16]. Available from: https:\/\/www.aaaai.org."},{"issue":"6","key":"10793_CR17","doi-asserted-by":"publisher","first-page":"489","DOI":"10.2500\/aap.2014.35.3791","volume":"35","author":"S Albin","year":"2014","unstructured":"Albin S, Agarwal S. Prevalence and characteristics of reported penicillin allergy in an urban outpatient adult population. Allergy Asthma Proc. 2014;35(6):489\u201394.","journal-title":"Allergy and Asthma Proceedings."},{"issue":"3","key":"10793_CR18","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1093\/cid\/cix794","volume":"66","author":"KG Blumenthal","year":"2018","unstructured":"Blumenthal KG, Ryan EE, Li Y, Lee H, Kuhlen JL, Shenoy ES. The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk. Clin Infect Dis. 2018;66(3):329\u201336.","journal-title":"Clinical Infectious Diseases."},{"issue":"10167","key":"10793_CR19","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/S0140-6736(18)32218-9","volume":"393","author":"KG Blumenthal","year":"2019","unstructured":"Blumenthal KG, Peter JG, Trubiano JA, Phillips EJ. Antibiotic allergy. The Lancet. 2019;393(10167):183\u201398.","journal-title":"The Lancet."},{"key":"10793_CR20","unstructured":"CDC. Penicillin Allergy - STI Treatment Guidelines [Internet]. 2021 [cited 2026 Mar 16]. Available from: https:\/\/www.cdc.gov\/std\/treatment-guidelines\/penicillin-allergy.htm."},{"key":"10793_CR21","doi-asserted-by":"crossref","unstructured":"Picard M, Robitaille G, Karam F, et al. Cross-Reactivity to Cephalosporins and Carbapenems in Penicillin-Allergic Patients: Two Systematic Reviews and Meta-Analyses. J Allergy Clin Immunol: In Practice. 2019;7(8):2722\u20132738.e5.","DOI":"10.1016\/j.jaip.2019.05.038"},{"issue":"1","key":"10793_CR22","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.5435\/JAAOS-D-21-00422","volume":"30","author":"S Sarfani","year":"2022","unstructured":"Sarfani S, Stone CA, Murphy GA, Richardson DR. Understanding Penicillin Allergy, Cross-reactivity, and Antibiotic Selection in the Preoperative Setting. J Am Acad Orthop Surg. 2022;30(1):e1\u20135.","journal-title":"The Journal of the American Academy of Orthopaedic Surgeons."},{"issue":"4","key":"10793_CR23","doi-asserted-by":"publisher","first-page":"142","DOI":"10.5415\/apallergy.0000000000000122","volume":"13","author":"PH Li","year":"2023","unstructured":"Li PH, Thong BYH, Pawankar R, et al. APAAACI clinical pathway on direct provocation testing for penicillin allergy delabeling. Asia Pacific Allergy. 2023;13(4):142\u20137.","journal-title":"Asia Pacific allergy."},{"issue":"6","key":"10793_CR24","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1093\/cid\/ciaa194","volume":"72","author":"B Sousa-Pinto","year":"2020","unstructured":"Sousa-Pinto B, Blumenthal KG, Macy E, et al. Penicillin Allergy Testing Is Cost-Saving: An Economic Evaluation Study. Clin Infect Dis. 2020;72(6):924\u201338.","journal-title":"Clinical Infectious Diseases."},{"issue":"1","key":"10793_CR25","doi-asserted-by":"publisher","DOI":"10.3389\/falgy.2020.586301","volume":"16","author":"T Hills","year":"2020","unstructured":"Hills T, Arroll N, Duffy E, Capstick J, Jordan A, Fitzharris P. Penicillin Allergy De-labeling Results in Significant Changes in Outpatient Antibiotic Prescribing Patterns. Front Allergy. 2020;1:586301.","journal-title":"Frontiers in Allergy."}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-026-10793-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-026-10793-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-026-10793-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:17:47Z","timestamp":1788884267000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-026-10793-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,8]]},"references-count":25,"alternative-id":["10793"],"URL":"https:\/\/doi.org\/10.1007\/s11606-026-10793-w","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,8]]},"assertion":[{"value":"23 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethics approval was not required for this narrative review.","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Patient consent was not required for this narrative review.","order":2,"name":"Ethics","label":"Informed Consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they do not have a conflict of interest.","order":3,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Clinical Trial Number: Not applicable.","order":4,"name":"Ethics","label":"Clinical Trial Number","group":{"name":"EthicsHeading","label":"Declarations"}}]}}