{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T13:22:09Z","timestamp":1793020929098,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T00:00:00Z","timestamp":1491350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Self\u2010reported penicillin allergy is common among patients attending the ED, but is a poor predictor of true immunoglobulin E\u2010mediated hypersensitivity to penicillin. We hypothesise that with a combination of skin testing and drug provocation testing, selected patients can be safely de\u2010labelled of their allergy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study enrolled a sample of patients presenting to an urban academic ED between 2011 and 2016 with a self\u2010reported allergy to penicillin. Standardised skin prick and intradermal testing with amoxicillin and both major and minor determinants of penicillin was performed in the department. If negative, testing was followed by a graded oral challenge of amoxicillin over 9 days. The primary end point was the allergy status of participants at the end of the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 100 patients (mean age 42; standard deviation 14 years; 54% women) completed the testing. Of these, 81% (95% confidence interval 71.9\u201388.2) showed no hypersensitivity to penicillin and were labelled non\u2010allergic. The majority (16\/19) of allergies were confirmed by skin testing, with three suspected allergies detected by the oral challenge. Women were more likely than men to have a true penicillin allergy, with odds ratio of 4.0 (95% confidence interval 1.23\u201313.2). There were no serious adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Selected patients in the ED who self\u2010report an allergy to penicillin can be safely tested there for penicillin allergy, using skin tests and oral drug provocation testing. This testing allows a significant de\u2010labelling of penicillin allergy, with the majority of these patients able to tolerate penicillin without incident.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.12774","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T19:12:03Z","timestamp":1491419523000},"page":"509-515","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["De\u2010labelling self\u2010reported penicillin allergy within the emergency department through the use of skin tests and oral drug provocation testing"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3698-6823","authenticated-orcid":false,"given":"Joseph","family":"Marwood","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Aguirrebarrena","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Kerr","sequence":"additional","affiliation":[{"name":"The Kirby Institute The University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan A","family":"Welch","sequence":"additional","affiliation":[{"name":"Department of Pharmacy St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Rimmer","sequence":"additional","affiliation":[{"name":"St Vincent's Clinic  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,5]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"226","article-title":"On the antibacterial action of cultures of a penicillium, with special reference to their use in the isolation of B. influenzae","volume":"10","author":"Fleming A","year":"1929","journal-title":"Br. 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