{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:59:17Z","timestamp":1793134757544,"version":"4.5.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":54,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,29]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In high-income countries, up to 25% of inpatients have a self-reported penicillin allergy (PA). After testing, 95% of these self-reported PAs are incorrect. These incorrectly labelled PAs increase the use of broad-spectrum antibiotics, and drive bacterial resistance. The epidemiology of PA in low- and middle-income countries is unknown. We aimed to describe the epidemiology and delabelling outcomes of self-reported PA in South African (SA) inpatients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted point prevalence surveys between April 2019 and June 2021 at seven hospitals in Cape Town, South Africa. A team trained in the PEN-FAST allergy decision tool conducted in-person interviews, and reviewed patient notes to identify and risk stratify inpatients with a self-reported PA. These patients were referred to the Groote Schuur Hospital (GSH) allergy clinic for delabelling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1486 hospital inpatients were surveyed and 3.2% (n\u200a=\u200a48) carried a PA label. Importantly, 64.6% (n\u200a=\u200a31) were classified by PEN-FAST as low risk for true penicillin hypersensitivity. Overall, 25% of the self-reported PAs received a \u03b2-lactam antibiotic in hospital and were directly delabelled. Delabelling attrition was very high, with 6.3% (3\/48) of the self-reported PAs attending the GSH allergy clinic, and only one patient proceeding to a negative oral penicillin challenge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Inpatient self-reported PA was lower in South Africa hospitals compared with other upper-middle-income countries, and the majority of patients carried a low-risk PA label. Linkage for delabelling with the allergy clinic was very poor, and thus strategies to improve access and delivery of delabelling remains an urgent public health issue.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jacamr\/dlad015","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T19:41:36Z","timestamp":1677008496000},"source":"Crossref","is-referenced-by-count":8,"title":["Low self-reported penicillin allergy in South Africa\u2014implications for global public health response"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8090-3861","authenticated-orcid":false,"given":"Cascia","family":"Day","sequence":"first","affiliation":[{"name":"Division of Allergology and Clinical Immunology, Department of Medicine, Faculty of Health Sciences, University of Cape Town , Cape Town , South Africa"},{"name":"Allergy and Immunology Unit, University of Cape Town Lung Institute , Mowbray, Cape Town , South 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