{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T09:59:27Z","timestamp":1781603967851,"version":"3.54.5"},"reference-count":49,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                  <jats:p>Penicillin allergy labels are the most common drug allergy label. The objective of this study was to describe the quality and management of penicillin allergy labels in the pediatric primary care setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Retrospective chart review of 500 of 18 015 children with penicillin allergy labels born from January 1, 2010 to June 30, 2020 randomly selected from an outpatient birth cohort from Texas Children\u2019s Pediatrics and Children\u2019s Hospital of Philadelphia networks. Penicillin allergy risk classification (\u201cnot allergy,\u201d \u201clow risk,\u201d \u201cmoderate or high risk,\u201d \u201csevere risk,\u201d \u201cunable to classify\u201d) was determined based on documentation within (1) the allergy tab and (2) electronic healthcare notes. Outcomes of allergy referrals and penicillin re-exposure were noted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Half of penicillin allergy labels were \u201cunable to classify\u201d based on allergy tab documentation. Risk classification agreement between allergy tabs and healthcare notes was fair (Cohen\u2019s \u0138 = 0.35 \u00b1 0.02). Primary care physicians referred 84 of 500 (16.8%) children to an allergist, but only 54 (10.8%) were seen in allergy clinic. All children who were challenged (25 of 25) passed skin testing. Removal of allergy labels was uncommon (69 of 500, 13.8%) but occurred more often following allergy appointments (26 of 54, 48%) than not (43 of 446, 9.6%, P &amp;lt; .001). Children delabeled by primary care physicians were as likely to tolerate subsequent penicillin-class antibiotics as those delabeled by an allergist (94% vs 93%, P = .87).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Penicillin allergy documentation within the allergy tab was uninformative, and children were infrequently referred to allergists. Future quality improvement studies should improve penicillin allergy documentation and expand access to allergy services.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2022-059309","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T08:06:56Z","timestamp":1675670816000},"source":"Crossref","is-referenced-by-count":12,"title":["The Quality and Management of Penicillin Allergy Labels in Pediatric Primary Care"],"prefix":"10.1542","volume":"151","author":[{"given":"Margaret G.","family":"Taylor","sequence":"first","affiliation":[{"name":"aDivision of Infectious Diseases"},{"name":"bDepartment of Pediatrics, Baylor College of Medicine, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Joerger","sequence":"additional","affiliation":[{"name":"cDivision of Infectious Diseases"},{"name":"eDivision of Immunology, Allergy, and Retrovirology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Anvari","sequence":"additional","affiliation":[{"name":"bDepartment of Pediatrics, Baylor College of Medicine, Texas Children\u2019s Hospital, Houston, Texas"},{"name":"eDivision of Immunology, Allergy, and Retrovirology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Li","sequence":"additional","affiliation":[{"name":"eDivision of Immunology, Allergy, and Retrovirology"},{"name":"fPediatric IDEAS Research Group of the Center for Pediatric Clinical Effectiveness"},{"name":"gDepartment of Biostatistics, Epidemiology, and Informatics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S.","family":"Gerber","sequence":"additional","affiliation":[{"name":"cDivision of Infectious Diseases"},{"name":"dDepartment of Pediatrics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"hPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra L.","family":"Palazzi","sequence":"additional","affiliation":[{"name":"aDivision of Infectious Diseases"},{"name":"bDepartment of Pediatrics, Baylor College of Medicine, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,2,6]]},"reference":[{"issue":"5","key":"2023111014040094100_B1","doi-asserted-by":"crossref","first-page":"e20172497","DOI":"10.1542\/peds.2017-2497","article-title":"Antibiotic allergy in pediatrics","volume":"141","author":"Norton","year":"2018","journal-title":"Pediatrics"},{"issue":"11","key":"2023111014040094100_B2","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/s11882-014-0476-y","article-title":"Penicillin and beta-lactam allergy: epidemiology and diagnosis","volume":"14","author":"Macy","year":"2014","journal-title":"Curr 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