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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.


View Our Outpaitent Tool Kit

Expansion to Inpatient Areas Underway

Screenshot of nursing handout for penicillin allergy assessments


The next phase of work includes developing resources to expand assessments to the inpatient areas of UNC Medical Center. An Inpatient Guide to Penicillin Allergy Assessments describes the protocol in detail. The March 2023 pharmacist learning session offers additional details.

Outpatient Tool Kit

These allergies can be evaluated by a trained pharmacist or physician. The outpatient tool kit below has been created to educate patients and their caregivers and to train healthcare providers on how to assess penicillin allergies proactively. 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.

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.

Outpatient Penicillin Allergy Assessment Toolkit

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 for more information.