{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:28:04Z","timestamp":1785421684168,"version":"3.56.0"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science, Research and Arts Baden-W\u00fcrttemberg, Germany"},{"DOI":"10.13039\/501100001661","name":"Heidelberg University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001661","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/038t36y30","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Most penicillin allergy labels are documented in early childhood and result from events of low risk for allergy. In Germany, evidence-based strategies to evaluate the likelihood of a true penicillin allergy are still lacking. As general practitioner input is indispensable regarding required resources for the implementation of successful delabeling strategies in outpatient care, a mixed-methods study in Baden-W\u00fcrttemberg, Germany explored untapped delabeling potential and conditions for successful initiatives based on their experiences, to support preservation of penicillin as a treatment option and prevent resistance development. Methods: A cross-sectional convergent mixed-methods study was conducted with an online survey and semi-structured interviews. The survey link and invitation to participate in an interview was sent to randomly selected publicly available e-mail addresses. Survey data were analyzed descriptively. Qualitative data were analyzed inductively based on thematic analysis. Results: n = 101 survey questionnaires and n = 15 interviews were analyzed regarding relevance, experiences, framework conditions, and potential approaches to delabeling. All participants with limited recollection of the index reaction. Most participants considered delabeling a highly relevant topic in general practice. Delabeling efforts were discouraged by lack of time, expertise, and remuneration, and uncertainty due to missing guidelines. Taking a sufficient medical history and, if necessary, subsequent testing were seen as one approach to delabeling. For a standardized approach in primary care, patient and care provider education, precise guideline recommendations, and delabeling expert teams were suggested. Conclusions: The findings mirror aspects already identified in international research. A nationwide survey with general practitioners could confirm that addressing necessary resources and systemic adjustments would support effective penicillin allergy delabeling in outpatient care.<\/jats:p>","DOI":"10.3390\/antibiotics15040399","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T08:11:18Z","timestamp":1776240678000},"page":"399","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Penicillin Allergy, Really?\u2014A Cross-Sectional Mixed-Methods Study in Baden-W\u00fcrttemberg, Germany, to Explore General Practitioner Perspectives on Delabeling Potential in Primary Care"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0618-4034","authenticated-orcid":false,"given":"Regina","family":"Po\u00df-Doering","sequence":"first","affiliation":[{"name":"Department of Primary Care and Health Services Research, University Hospital Heidelberg, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola A.","family":"Litke","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Health Services Research, University Hospital Heidelberg, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Khatamzas","sequence":"additional","affiliation":[{"name":"Infectious Disease and Tropical Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"Altiner","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Health Services Research, University Hospital Heidelberg, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"k2400","DOI":"10.1136\/bmj.k2400","article-title":"Risk of meticillin resistant Staphylococcus aureus and Clostridium difficile in patients with a documented penicillin allergy: Population based matched cohort study","volume":"361","author":"Blumenthal","year":"2018","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1001\/jamainternmed.2020.2227","article-title":"Association between penicillin allergy documentation and antibiotic use","volume":"180","author":"Blumenthal","year":"2020","journal-title":"JAMA Intern. 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