Is penicillin allergy de-labelling about to find its place in UK antimicrobial stewardship strategy?

Penicillin allergy records are common, often incorrect, limit antibiotic treatment options and associated with patient and health system harm. The large numbers of patients with penicillin allergy records and the paucity of allergists have led researchers to explore non-allergist delivered assessment of penicillin allergy records and removal of those inconsistent with allergy (called de-labelling). A recent systematic review and meta-analysis of the literature concludes non-allergist delivery of penicillin allergy de-labelling to be safe and effective. Several countries outside Europe have endorsed non-allergist de-labelling and produced national guidelines and toolkits for de-labelling, but until recently the UK lacked such guidance. In September 2022 the British Society of Allergy and Clinical Immunology (BSACI) produced their guidelines endorsing non-allergist delivered penicillin allergy de-labelling. These BSACI guidelines, coupled with the ongoing NIHR funded penicillin allergy de-labelling studies, will enable this important patient safety and antimicrobial stewardship intervention to become standard of care for NHS patients.