PADL - Penicillin allergy de-labelling

The recording of a recent local PADL (Penicillin Allergy De‑labelling) webinar, which saw excellent engagement with 157 attendees at peak, is now available to watch, and the accompanying intervention brief (“how‑to guide” for GP practices) can be accessed here.

While community pharmacy teams are not directly involved in delivery of the current project, awareness is important as you may see increasing numbers of patients who have been reviewed or de‑labelled. Key highlights from the session include:

• Scale of the problem: Around 6–20% of patients have a penicillin allergy label, but over 90% are not truly allergic
• Clinical impact: Incorrect allergy labels lead to use of broader‑spectrum antibiotics, increased side‑effects and contribute to antimicrobial resistance
• Patient safety priority: PADL is a key patient safety and antimicrobial stewardship initiative aiming to improve prescribing quality
• What this means for community pharmacy: You may see changes to patients’ recorded allergies and increased use of first‑line penicillins where previously avoided
• Low‑risk patients first: Reviews will focus on very low‑risk patients, i.e. those who have subsequently tolerated penicillin without reaction
• Most reactions are not true allergy: Many reported reactions (e.g. childhood rashes) are more likely due to viral illness or side‑effects
• Simple, evidence‑based approach: Structured history‑taking and risk assessment tools are being used in primary care to support safe de‑labelling
• Clear pathways: Patients who are not suitable for simple de‑labelling are referred on to specialist services (but there will be a waiting list for this until pathway is redesigned)
• Reassurance on safety: Most suitable patients can be safely de‑labelled without complex testing
• Role of community pharmacy teams:
  • Be aware of updated allergy status in patient records
  • Support patient reassurance if queries arise about allergy removal
  • Continue to promote appropriate antibiotic use in line with stewardship principles and local SCAN guidelines
• Big impact from small steps: Even small numbers of de‑labels can improve outcomes and reduce antimicrobial resistance over time

We encourage you to watch the recording and review the resources, so you feel confident supporting patients and colleagues as this work progresses.