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History-based penicillin allergy de-labelling in adults

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About 6% of the UK general population have a penicillin allergy label on their record. Evidence indicates that more than 90% of patients labelled with a penicillin allergy are not allergic to penicillin when formally assessed. In many cases, the allergy label may be due to an adverse reaction that occurred during a course of penicillin in childhood. In addition, many patients’ reactions to penicillin occurred over 10 years ago and details of the reaction are not recalled. Furthermore, in up to 80% of patients, sensitivity can be lost, and individuals can become tolerant to penicillin after 10 years. There is increasing evidence that incorrect penicillin allergy labels can result in patients receiving suboptimal alternative antibiotic treatment and this may lead to worse outcomes.

This guidance is relevant to all registered healthcare professionals and can be used to support identification of people who have a very low risk of having a true penicillin allergy, for whom it is safe to remove the penicillin allergy label based on history alone. The resource includes practical materials such as patient information leaflets, an assessment template, posters, letter templates and allergy cards.

History-based penicillin allergy de-labelling in adults 1MB (PDF)

Published - July 2026

 

Appendices

Appendix 1. Penicillin de-labelling EMIS search 5KB (.xml)
Appendix 2. Contacting people to explore de-labelling – SMS message (English and Welsh) 83KB (PDF)
Appendix 3. Allergy to penicillin – Patient information leaflet (English and Welsh) 104KB (PDF)
Appendix 4. One-page CAPTURE penicillin allergy assessment 195KB (PDF)
Appendix 5. Penicillin de-labelling EMIS CAPTURE assessment template 18KB (.xml)
Appendix 6. Allergy card (English and Welsh) 380KB (PDF)
Appendix 7. Outcome communication and satisfaction survey invitation – SMS (English and Welsh) 83KB (PDF)
Appendix 8. Satisfaction survey 119KB (PDF)
Appendix 9. Template letter for GP, community pharmacy, other healthcare providers 97KB (PDF)
Appendix 10. Poster for waiting areas (English and Welsh) 208KB (PDF)

 

Equality and Health Impact Assessment (EqHIA) form

History-based penicillin allergy de-labelling in adults EqHIA

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