Innovative Algorithm Aims to Correct False Penicillin Allergy Labels in Community Pharmacy Settings

A team of researchers from Monash University has developed and piloted a new algorithm designed to identify and de-label incorrect penicillin allergy labels among patients visiting community pharmacies. Mislabeling of penicillin allergy is common, often based on side effects like nausea or headaches rather than true immune responses, which occur in less than 1% of the population. These mislabels, known as 'Type A' or non-immune-mediated reactions, lead to unnecessary avoidance of penicillin and other narrow-spectrum antibiotics.

The primary goal of this algorithm is to enhance patient safety and combat antimicrobial resistance (AMR) by reducing the prescription of broad-spectrum antibiotics driven by inaccurate allergy labels. The study was conducted over seven weeks across five metropolitan pharmacies in Victoria, involving 18,646 patients. Out of these, 163 patients had penicillin allergy labels, and approximately 18.4% of these were identified as having a non-immune reaction history.

Led by experts from the Faculty of Pharmacy and Pharmaceutical Sciences, this initiative focused on empowering pharmacists to conduct allergy assessments efficiently. Pharmacy students trained in implementing the algorithm approached patients, asking validated questions related to antibiotic allergy. Results showed that over 77% of patients with non-immune reactions were receptive to education and de-labeling, whereas about 23% expressed hesitation, often due to disbelief about their allergy status.

Addressing incorrect allergy labels enables the use of first-line antibiotics, thereby improving treatment outcomes and reducing the reliance on broad-spectrum options that contribute to antimicrobial resistance. The study underscores the importance of community pharmacists in antimicrobial stewardship efforts, utilizing straightforward algorithms to support clinical decision-making. The work was published in the journal Infection, Disease & Health and highlights the valuable role pharmacists can play in improving antibiotic prescribing practices.

For further details, see the full publication: Implementation of a proposed algorithm to assess and de-label false penicillin allergy labels in the community (source: https://medicalxpress.com/news/2025-05-algorithm-de-false-penicillin-allergy.html).