{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T08:57:57Z","timestamp":1780563477232,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001530","name":"Canterbury Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Penicillin allergy is the most reported adverse drug reaction (ADR). Being labelled with \u2018penicillin allergy\u2019 is associated with suboptimal antibiotic therapy and poor patient outcomes. Most labelled with \u2018penicillin allergy\u2019 are at low risk of harm from penicillins and guidelines recommend testing for accurate diagnosis. Although skin testing is recommended to exclude immunoglobulin E (IgE)\u2010mediated reactions, there is limited access in most settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate oral amoxicillin challenge without prior skin testing for patients labelled with \u2018penicillin allergy\u2019 assessed as low risk during hospital admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>General Medical inpatients with a \u2018penicillin allergy\u2019 label were assessed. For those who had tolerated a penicillin since the index event, the ADR label was removed. Those assessed as \u2018low risk\u2019 were administered 250 mg amoxicillin orally without prior skin testing. The durability of de\u2010labelling was subsequently assessed by review of clinical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 224 patients with a history of a penicillin ADR, 162 (72%) were low risk. A further 12 were excluded and of the remaining 150, 56 (37%) had tolerated penicillins since their index reaction and were de\u2010labelled without challenge, 15 (10%) with a non\u2010allergic history were de\u2010labelled. The remaining 79 were offered an oral amoxicillin challenge; 38 declined and 41 tolerated amoxicillin. Overall, 112 of the 224 (50%) patients had their ADR label removed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A careful ADR history enables de\u2010labelling of many patients. An oral amoxicillin challenge without prior skin testing is safe and feasible for low\u2010risk penicillin allergic patients while in hospital.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14978","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T15:56:00Z","timestamp":1594914960000},"page":"295-300","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Oral amoxicillin challenge for low\u2010risk penicillin allergic patients"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2820-4721","authenticated-orcid":false,"given":"Silabhakta","family":"Livirya","sequence":"first","affiliation":[{"name":"General Medicine Hawke's Bay Hospital  Hastings New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Pithie","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, General Medicine Christchurch 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