{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T21:50:12Z","timestamp":1777758612599,"version":"3.51.4"},"reference-count":0,"publisher":"Rila Publications Ltd","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acute Med"],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:p>Background: Penicillin allergy labels affect 6-10% of the UK population, yet over 95% are inaccurate. These labels drive unnecessary broad-spectrum antibiotic use, antimicrobial resistance, healthcare costs, adverse patient outcomes and carbon emissions.\nMethods: This pilot study embedded a penicillin allergy de-labelling (PADL) clinic within an Acute Medical Unit, using a direct oral amoxicillin challenge for patients identified as low-risk for a true allergy to penicillin according to BSACI guidelines and PEN-FAST scoring. Primary outcomes were feasibility and safety. Secondary outcome was subsequent antibiotic prescribing patterns. Exploratory outcomes included retrospective economic, antimicrobial resistance and environmental impact modelling.\nResults: Sixty patients (mean age 56 years) were included in the study, of whom 59 (98%) were successfully de- labelled with one delayed type IV reaction but no anaphylaxis. Following de-labelling, 35% received subsequent antibiotic therapy and all were prescribed penicillin-based therapy. Retrospective analysis revealed antibiotic costs were approximately tenfold higher (\u00a319,364 versus \u00a32,092) due to allergy labels. Multidrug-resistant organisms were present in 47% of patients and 37% received unnecessary intravenous antibiotics.\nConclusion: This pilot suggests that AMUembedded penicillin delabelling is safe and feasible, and may be associated with important clinical, economic, antimicrobial stewardship and environmental benefits that warrant confirmation in larger studies.<\/jats:p>","DOI":"10.52964\/amja.1017","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:10:26Z","timestamp":1777468226000},"page":"125-131","source":"Crossref","is-referenced-by-count":0,"title":["Embedding penicillin  de-labelling in the AMU: a feasibility and safety pilot study with exploratory economic and environmental analysis"],"prefix":"10.52964","volume":"24","author":[{"given":"Bernice","family":"Ng","sequence":"first","affiliation":[{"name":"MB, Acute Medical Unit, Royal Victoria Hospital, Belfast Health and Social Care Trust, Grosvenor Road, Belfast."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"McGuigan","sequence":"additional","affiliation":[{"name":"MB, Acute Medical Unit, Royal Victoria Hospital, Belfast Health and Social Care Trust, Grosvenor Road, Belfast."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Allen","sequence":"additional","affiliation":[{"name":"MB, Acute Medical Unit, Royal Victoria Hospital, Belfast Health and Social Care Trust, Grosvenor Road, Belfast."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Brennan-Finucane","sequence":"additional","affiliation":[{"name":"Centre for Medical Education, School of Medicine, Dentistry and Biomedical Sciences; Queen\u2019s University Belfast, 97 Lisburn Road, Belfast."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ois\u00edn","family":"Toner","sequence":"additional","affiliation":[{"name":"Centre for Medical Education, School of Medicine, Dentistry and Biomedical Sciences; Queen\u2019s University Belfast, 97 Lisburn Road, Belfast."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Brady","sequence":"additional","affiliation":[{"name":"PhD, Acute Medical Unit, Royal Victoria Hospital, Belfast Health and Social Care Trust, Grosvenor Road, Belfast & School of Pharmacy, Queen\u2019s University Belfast, 97 Lisburn Road, Belfast & Pharmacy Department, Belfast Health and Social Care Trust, Grosvenor Road, Belfast."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Toner","sequence":"additional","affiliation":[{"name":"MB PhD, Acute Medical Unit, Royal Victoria Hospital, Belfast Health and Social Care Trust, Grosvenor Road, Belfast & Centre for Medical Education, School of Medicine, Dentistry and Biomedical Sciences; Queen\u2019s University Belfast, 97 Lisburn Road, Belfast"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"30823","published-online":{"date-parts":[[2025,7,1]]},"container-title":["Acute Medicine Journal"],"original-title":[],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:10:30Z","timestamp":1777468230000},"score":1,"resource":{"primary":{"URL":"https:\/\/acutemedjournal.co.uk\/embedding-penicillinde-labelling-in-the-amu-a-feasibility-and-safety-pilot-study-with-exploratory-economic-and-environmental-analysis\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,7,1]]},"published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.52964\/amja.1017","relation":{},"ISSN":["1747-4884"],"issn-type":[{"value":"1747-4884","type":"print"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}