Patients who may have been mis-labelled as allergic to penicillin could be offered a dose to demonstrate that they can take it without harm, following a new trial.
Funded by the National Institute for Health and Care Research, the trial was conducted in three hospitals, exploring the viability of non-allergy specialist professionals delivering direct oral penicillin 'challenges'.
Low-risk patients believing they have a penicillin allergy received an oral dosage and were subsequently watched closely.
More than 2,000 suitable patients were considered, and following screening, 126 were invited to participate in the trial conducted by Oxford University Hospitals NHS Foundation Trust, University Hospitals Birmingham NHS Foundation Trust, and Leeds Teaching Hospitals NHS Trust.
Those participating were given an oral dose of amoxicillin by a research nurse or a pharmacist in a supervised clinical environment, with immediate access to resuscitation facilities if necessary.
The results showed 122 out of the 126 participants - 97 per cent - did not have a penicillin allergy, and no severe hypersensitivity reactions were recorded.
Lead investigator of the study, Professor Mamidipudi Thirumala Krishna, said: "Inaccurate penicillin allergy labels are a huge burden globally.
"In high-income countries, such as UK and USA six to 10 percent of the population believe that they are allergic.
"Penicillin allergy labels are not benign and contribute to antimicrobial resistance, so enabling more patients to safely benefit from penicillin will ease the burden of other antibiotics that are currently being overused and improve quality of clinical care.
"In our feasibility study, we showed how a closely monitored protocol for taking penicillin directly, rather than using a skin allergy test which needs to be delivered by an allergy specialist, was effective in low-risk patients."
Co-senior author of the study, Dr Siraj Misbah added: "Inaccurate labels of penicillin allergy constitute a major public health challenge because of its adverse consequences for the individual due to restricted antibiotic access and for wider public health because of its negative impact on antimicrobial resistance and stewardship.
"By demonstrating that allied healthcare professionals with no previous background in allergy are capable of removing a penicillin allergy label, this study provides a low-cost framework for adoption by healthcare systems."
Doctor Louise Savic said: "This study demonstrates that a routine programme of de-labelling people who believe they are allergic to penicillin, outside the setting of a specialist allergy clinic, is potentially achievable.
"De-labelling was particularly successful within the outpatient population, suggesting that future efforts might be best targeted to this group in order to maximise benefit."
The results of this trial indicated that deliberate penicillin 'challenges', under the supervision of professionals, can effectively dispel the false belief of penicillin allergy.
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