{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:49Z","timestamp":1787014069067,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T00:00:00Z","timestamp":1757808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T00:00:00Z","timestamp":1757808000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Self\u2010reported penicillin allergies lead to the use of broad\u2010spectrum antibiotics, increase drug resistance, and constitute an economic burden. The PEN\u2010FAST score aims to identify low\u2010risk patients for direct drug provocation tests (DPT) without prior skin testing with a reported negative predictive value (NPV) of over 95%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>In this single\u2010center study (Department of Dermatology, University Hospital Heidelberg, Germany), the PEN\u2010FAST score was evaluated for patients carrying a penicillin allergy label between 2004 and 2024. Skin testing, allergen\u2010specific IgE, and consecutive DPT were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 189 patients were analyzed. In a retrospective cohort, 106 of 149 patients showed negative skin tests and received DPT, leading to the delabeling of 99 patients (66.4%). PEN\u2010FAST identified 55 of 149 (36.9%) as low\u2010risk, of which three low\u2010risk patients were misclassified. In a prospective PEN\u2010FAST low\u2010risk cohort, one of 40 patients showed a mild reaction after DPT. Overall, NPVs of both PEN\u2010FAST and formal allergy testing were 95.8%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results advocate for direct DPT in patients carrying a penicillin allergy label classified as low\u2010risk by PEN\u2010FAST. PEN\u2010FAST demonstrated high NPV, safety, and feasibility in a cohort with a high prevalence of true allergies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ddg.15862","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T05:57:29Z","timestamp":1757915849000},"page":"57-63","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Implementing PEN\u2010FAST for penicillin allergy delabeling in a high\u2010prevalence population"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8019-7144","authenticated-orcid":false,"given":"Deniz","family":"G\u00f6cebe","sequence":"first","affiliation":[{"name":"Department of Dermatology University Hospital Heidelberg Heidelberg University  Heidelberg 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