{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:16:40Z","timestamp":1792001800997,"version":"4.4.0"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T00:00:00Z","timestamp":1678060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Health Education England Research Internship for Pharmacists"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Penicillin allergy labels are commonly acquired in childhood and lead to avoidance of first-line penicillin antibiotics. Understanding the health outcomes of penicillin allergy testing (PAT) can strengthen its place in antimicrobial stewardship efforts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To identify and summarize the health outcomes of PAT in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Embase, MEDLINE, Web of Science, Cochrane Library, SCOPUS and CINAHL were searched from inception to 11 Oct 2021 (Embase and MEDLINE updated April 2022). Studies that utilized in vivo PAT in children (\u226418 years old) and reported outcomes relevant to the study objectives were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty-seven studies were included in the review, with a total of 8411 participants. The most commonly reported outcomes were delabelling, subsequent penicillin courses, and tolerability to penicillin courses. Ten studies had patient-reported tolerability to subsequent penicillin use, with a median 93.6% (IQR 90.3%\u201397.8%) of children tolerating a subsequent course of penicillins. In eight studies, a median 97.3% (IQR 96.4%\u201399.0%) of children were reported as \u2018delabelled\u2019 after a negative PAT without further definition. Three separate studies verified delabelling by checking electronic or primary care medical records, where 48.0%\u201368.3% children were delabelled. No studies reported on outcomes relating to disease burden such as antibiotic resistance, mortality, infection rates or cure rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Safety and efficacy of PAT and subsequent penicillin use was the focus of existing literature. Further research is required to determine the long-term impact of delabelling penicillin allergies on disease burden.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkad052","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T06:03:51Z","timestamp":1678169031000},"page":"913-922","source":"Crossref","is-referenced-by-count":15,"title":["Health outcomes of penicillin allergy testing in children: a systematic review"],"prefix":"10.1093","volume":"78","author":[{"given":"Mo","family":"Kwok","sequence":"first","affiliation":[{"name":"Department of Pharmacy, University Hospitals Plymouth NHS Trust , Plymouth , UK"},{"name":"Department of Pharmacy and Pharmacology, University of Bath , Bath , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie L","family":"Heard","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Somerset NHS Foundation Trust , Taunton , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"May","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University Hospitals Plymouth NHS Trust , Plymouth , UK"},{"name":"Department of Pharmacy and Pharmacology, University of Bath , Bath , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Pilgrim","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Royal United Hospitals Bath NHS Foundation Trust , Bath , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0193-8677","authenticated-orcid":false,"given":"Jonathan","family":"Sandoe","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Leeds , Leeds , UK"},{"name":"School of Medicine, Leeds Teaching Hospitals NHS Trust , Leeds , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Tansley","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Pharmacology, University of Bath , Bath , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Pharmacology, University of Bath , Bath , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,6]]},"reference":[{"key":"2023040308030283900_","doi-asserted-by":"crossref","first-page":"e222117","DOI":"10.1001\/jamanetworkopen.2022.2117","article-title":"Factors associated with penicillin allergy labels in electronic health records of children in 2 large US pediatric primary care networks","volume":"5","author":"Taylor","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2023040308030283900_","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/j.jaip.2020.08.047","article-title":"Differentiating between \u03b2-lactam-induced serum sickness-like reactions and viral exanthem in children using a graded oral challenge","volume":"9","author":"Colli","year":"2021","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2023040308030283900_","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/all.13848","article-title":"The challenge of de-labeling penicillin allergy","volume":"75","author":"Stone","year":"2020","journal-title":"Allergy"},{"key":"2023040308030283900_","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1016\/j.jaip.2017.12.033","article-title":"The cost of self-reported penicillin allergy: a systematic review","volume":"6","author":"Mattingly","year":"2018","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2023040308030283900_","doi-asserted-by":"crossref","first-page":"k2400","DOI":"10.1136\/bmj.k2400","article-title":"Risk of meticillin resistant Staphylococcus aureus and Clostridium difficile in patients with a documented penicillin allergy: population based matched cohort study","volume":"361","author":"Blumenthal","year":"2018","journal-title":"BMJ"},{"key":"2023040308030283900_","doi-asserted-by":"crossref","first-page":"S61","DOI":"10.1093\/ofid\/ofz359.134","article-title":"1957. 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