{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:53:06Z","timestamp":1785433986199,"version":"3.56.0"},"reference-count":9,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"unspecified","delay-in-days":46,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2732494X26102976_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Penicillins are the most frequently prescribed antibiotics for a broad range of infections. In North America, up to 15% of hospitalized patients report a penicillin allergy, but research has shown that 98% of these patients can tolerate penicillins. Removing inaccurate allergy labels is an essential component of antimicrobial stewardship. While allergy delabelling used to be complex or require an allergist referral, the emergence of new tools, such as the PEN-FAST score, facilitates direct delabeling of low-risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26102976_as2\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The primary objective of this study was to trial the use of the PEN-FAST scoring tool at a major tertiary care center in Canada. Secondary objectives included measuring the pharmacy workload associated with the delabeling process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26102976_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective pilot study was implemented at a Canadian tertiary care hospital to identify new patients with a penicillin allergy label, perform a review of their medical history, obtain a PEN-FAST score, and if applicable, implement an oral challenge with amoxicillin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26102976_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Most of the 155 screened patients were delabeled based on their medical history. Twenty-nine patients were eligible for an oral challenge, and three challenges were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26102976_as5\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>PEN-FAST scoring in combination with direct oral challenge is a practical tool that can be prospectively implemented by pharmacists.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ash.2026.10297","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T07:38:34Z","timestamp":1771227514000},"source":"Crossref","is-referenced-by-count":1,"title":["Feasibility and impact of pharmacist-led penicillin allergy delabelling using the PEN-FAST scoring tool in a Canadian tertiary care hospital"],"prefix":"10.1017","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8198-6235","authenticated-orcid":false,"given":"Claire","family":"Kamaliddin","sequence":"first","affiliation":[{"name":"The University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Driver","sequence":"additional","affiliation":[{"name":"University of Alberta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8859-7936","authenticated-orcid":false,"given":"Rebecca","family":"Druken","sequence":"additional","affiliation":[{"name":"Alberta Health Services"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9884-6423","authenticated-orcid":false,"given":"Elissa","family":"Rennert-May","sequence":"additional","affiliation":[{"name":"The University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4666-8391","authenticated-orcid":false,"given":"Irina","family":"Rajakumar","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02nt5es71","id-type":"ROR","asserted-by":"publisher"}],"name":"Alberta Health Services"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"S2732494X26102976_ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.2227"},{"key":"S2732494X26102976_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.09.259"},{"key":"S2732494X26102976_ref5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.anai.2021.07.005","article-title":"Predictive factors of amoxicillin immediate hypersensitivity and validation of PEN-FAST clinical decision rule","volume":"128","author":"Piotin","year":"2022","journal-title":"Ann Allergy Asthma Immunol"},{"key":"S2732494X26102976_ref1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12881"},{"key":"S2732494X26102976_ref6","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1001\/jamainternmed.2023.1572","article-title":"Evaluating the PEN-FAST clinical decision-making tool to enhance penicillin allergy delabeling","volume":"183","author":"Su","year":"2023","journal-title":"JAMA Intern Med"},{"key":"S2732494X26102976_ref3","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1001\/jama.2018.19283","article-title":"Evaluation and management of penicillin allergy: a review","volume":"321","author":"Shenoy","year":"2019","journal-title":"JAMA"},{"key":"S2732494X26102976_ref8","doi-asserted-by":"crossref","first-page":"e063784","DOI":"10.1136\/bmjopen-2022-063784","article-title":"Use of a penicillin allergy clinical decision rule to enable direct oral penicillin provocation: an international multicentre randomised control trial in an adult population (PALACE): study protocol","volume":"12","author":"Copaescu","year":"2022","journal-title":"BMJ Open"},{"key":"S2732494X26102976_ref7","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1001\/jamainternmed.2023.2986","article-title":"Efficacy of a clinical decision rule to enable direct oral challenge in patients with low-risk penicillin allergy: the PALACE randomized clinical trial","volume":"183","author":"Copaescu","year":"2023","journal-title":"JAMA Intern Med"},{"key":"S2732494X26102976_ref9","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.anai.2010.08.002","article-title":"Drug allergy: an updated practice parameter","volume":"105","year":"2010","journal-title":"Ann Allergy Asthma Immunol"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X26102976","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T09:21:48Z","timestamp":1783416108000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X26102976\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S2732494X26102976"],"URL":"https:\/\/doi.org\/10.1017\/ash.2026.10297","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e49"}}