Clinical Research Directory

Inclusion Criteria: 1. Penicillin allergy label 2. Age ≥18 3. Registered as a patient with University Hospital Southampton NHS Foundation Trust (with a UHS medical record) 4. Able and willing to consent to penicillin de-labelling Exclusion Criteria: 1. Penicillin allergy previously confirmed via positive blood, skin, BAT or challenge testing 2. PEN-FAST score \>2 (indicating a moderate or high risk of a positive challenge) 3. Anaphylaxis, angioedema, wheeze, shortness of breath or suspected hypotension linked to treatment with penicillin 4. Received treatment in hospital for a reaction linked to penicillin (unless already an inpatient at onset) 5. Itchy or urticarial rash within 1 hour of starting a new course of treatment with penicillin 6. Severe cutaneous adverse reaction (SCAR) linked to penicillin exposure (e.g. SJS/TEN, DRESS), including symptoms suggestive of SCAR without a formal diagnosis (e.g. skin blistering or peeling, mucosal involvement) 7. History of other serious, non-immediate reactions linked to penicillin (e.g. haemolytic anaemia, transaminitis, nephritis) 8. Currently pregnant or breastfeeding 9. Poorly controlled asthma 10. Severe COPD 11. Severe or critical aortic stenosis 12. Clinically unstable secondary to other organ failure 13. Unwell or unstable on the day of proposed penicillin challenge (including acute febrile illness) 14. Prescribed other antibiotics on the day of proposed challenge, unless taken as a long-term treatment/prophylaxis