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Penicillin Allergy Assessment Tool Kit

graphic of a tool kit with words penicillin allergy assessment tool kit

An estimated 10% of the US population reports having an allergic reaction to a penicillin-class antibiotic. However, when evaluated, fewer than 1% are truly allergic. Broad-spectrum antibiotics are a common alternative to penicillins and are associated with more side effects, higher healthcare costs, and antimicrobial resistance.

These allergies can be evaluated by a trained pharmacist or physician. The tool kit below has been created to educate patients and their caregivers and to train healthcare providers on how to proactively assess penicillin allergies. Removing the allergy from medical records of patients who are not truly allergic to penicillins is an important stewardship tool that decreases unnecessary use of broad-spectrum antibiotics.

outpatient penicillin allergy Assessment Tool Kit
Click to enlarge; UNC login required

The tool kit includes:

    • A visual big-picture overview of the allergy assessment process and associated resources
    • Penicillin Allergy Assessment Presentation: This 20-minute presentation provides background on penicillin allergies, healthcare outcomes associated penicillin allergies, and discusses how to conduct assessments using an Epic SmartPhrase.
    • Risk Stratification Chart assists with determining patient’s allergy risk based on their past allergic history
    • NIAID/FAAN Anaphylaxis Risk Chart: aids healthcare providers in identifying an anaphylactic reaction appropriately
    • Patient Education Materials
      • Patient Educational Fact Sheet describes why allergy assessment matters and its benefits
      • ¿Es alérgico a la penicilina? Información para pacientes
      • CDC Educational Fact Sheet: Is It Really a Penicillin Allergy? Evaluation and Diagnosis of Penicillin Allergy for Healthcare Professionals
      • Wallet Card: Fill and print for patients who have been de-labeled through your assessment as a reminder that they are no longer allergic.

The Penicillin Allergy Assessment Tool Kit is a collaboration of the UNC Medical Center’s Carolina Antimicrobial Stewardship Program, the UNC Division of Rheumatology, Allergy & Immunology, and the UNC Institute for Healthcare Quality Improvement. If you are interested in incorporating penicillin allergy assessments into your practice, please contact Mildred Kwan or Renae Boerneke for more information.

Information for Patients & Caregiverspatient fact sheet with link to PDF


  • The National Quality Forum‘s Antimicrobial Stewardship Playbook (2016) provides real-world ideas for application of the CDC’s Core Elements (see below)
  • Tools and resources for implementing antimicrobial stewardship from the Society for Healthcare Epidemiology of America (SHEA)
  • Resources on antimicrobial stewardship and resistance from the Infectious Diseases Society of America

The US Centers for Disease Control and Prevention and the Agency for Healthcare Quality and Research are two of several agencies of the U.S. Department of Health and Human Services charged with leading national efforts on antimicrobial use and resistance. Their websites provide a wealth of resources and information, including:

Infectious Diseases Fellowships

The University of North Carolina at Chapel Hill School of Medicine, in partnership with the UNC Medical Center, offers programs to develop the next generation of infectious diseases experts. Learn more about these opportunities:

Global & National Campaigns

  • cartoon of people engaged in antimicrobial stewardship, credit WHO

    World Antimicrobial Awareness Week takes place each November. Resources include a customizable poster-maker (scroll to bottom)  and other materials to amplify campaign messages globally.

  • The CDC is the U.S. lead agency for World Antimicrobial Awareness Week and provides a partner tool kit to make participation easier and coordinated across the U.S.


  • Antibiotic Resistance & Patient Safety Portal (formerly the Patient Safety Portal) allows users to explore and visual data on antibiotic resistance and healthcare-associated infections
  • CDC’s National Healthcare Safety Network (NHSN) publishes reports from its data on topics such as antimicrobial use and resistance, including antimicrobial-resistance pathogens associated with healthcare-associated infections