{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T03:06:22Z","timestamp":1779159982259,"version":"3.51.4"},"reference-count":12,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:00:00Z","timestamp":1777075200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Approximately 10% of US patients report a penicillin allergy, yet fewer than 1% have a true immunoglobulin E\u2013mediated reaction. Mislabeled allergies contribute to unnecessary use of broad-spectrum antibiotics, increasing healthcare costs, hospital stays, antimicrobial resistance, and mortality. Despite guideline recommendations for risk stratification and allergy delabeling, implementation remains limited. PEN-FAST is a validated clinical tool used to facilitate delabeling without resource-intensive skin testing. This study aimed to determine the prevalence of low-risk penicillin allergy among adult patients using the PEN-FAST tool within a pharmacist-led medication reconciliation process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter, retrospective prevalence study was conducted at 2 community hospitals. Patients admitted or seen in the emergency department from September 16 through December 16, 2024, with a documented penicillin allergy who underwent a pharmacist-performed PEN-FAST assessment were included. The primary outcome was the proportion of patients classified as having low-risk penicillin allergy (PEN-FAST score of &amp;lt;3). Secondary outcomes included allergy delabeling rates and the frequency of direct oral penicillin challenges. Descriptive analysis was used to evaluate the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 95 patients assessed, 74% (n = 70) were classified as low risk. Among these low-risk patients, 10% (n = 7) had their allergy label removed and 3% (n = 2) underwent a direct oral penicillin challenge, with both tolerating penicillin without adverse reactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that pharmacist-led PEN-FAST implementation is a feasible strategy to identify low-risk penicillin allergies, but allergy delabeling and oral challenge rates remain low. Further efforts are needed to integrate PEN-FAST into clinical workflows and enhance antimicrobial stewardship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajhp\/zxag129","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T11:45:34Z","timestamp":1777031134000},"source":"Crossref","is-referenced-by-count":0,"title":["Think PEN-FAST: Evaluation of implementing PEN-FAST into pharmacist-led medication reconciliation"],"prefix":"10.1093","author":[{"given":"Samantha","family":"Linville","sequence":"first","affiliation":[{"name":"SSM Health DePaul Hospital\u2013St.Louis , Bridgeton, MO ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Metzger","sequence":"additional","affiliation":[{"name":"SSM Health DePaul Hospital\u2013St.Louis , Bridgeton, MO ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Etemady-Deylamy","sequence":"additional","affiliation":[{"name":"SSM Health DePaul Hospital\u2013St.Louis , Bridgeton, MO ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manokiran","family":"Patri","sequence":"additional","affiliation":[{"name":"SSM Health DePaul Hospital\u2013St.Louis , Bridgeton, MO ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hunter O","family":"Rondeau","sequence":"additional","affiliation":[{"name":"SSM Health DePaul Hospital\u2013St.Louis , Bridgeton, MO ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,25]]},"reference":[{"key":"2026051822120258500_zxag129-B1","author":"Centers for Disease Control and 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update","volume":"150","author":"Khan","year":"2022","journal-title":"J Allergy Clin Immunol"},{"issue":"5","key":"2026051822120258500_zxag129-B8","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1001\/jamainternmed.2020.0403","article-title":"Development and validation of a penicillin allergy clinical decision rule","volume":"180","author":"Trubiano","year":"2020","journal-title":"JAMA Intern Med"},{"issue":"9","key":"2026051822120258500_zxag129-B9","doi-asserted-by":"publisher","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":"2026051822120258500_zxag129-B10","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.ajem.2025.01.039","article-title":"PEN-FAST-ED: utilizing the PEN-FAST decision 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