ArticlePharmacy (Basel, Switzerland)2026
Impact of a Pharmacist-Driven Penicillin Allergy De-Labeling Service (PADLS) on Hospitalized Patients.
Article in Pharmacy (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Penicillin (PCN) allergies are frequently reported despite a true prevalence of less than 1%, leading to unnecessary avoidance of beta-lactams, broader antimicrobial use, and increased healthcare costs. Pharmacist-driven de-labeling programs offer a strategy to improve antimicrobial stewardship. This single-center, retrospective study evaluated hospitalized adults with a documented PCN allergy and screened by the pharmacist-driven penicillin allergy de-labeling service (PADLS) between 16 January and 26 June 2025. Patients were categorized into a screened cohort and a Full Allergy Reconciliation (FAR) cohort if interviewed using PEN-FAST. Eligible patients underwent direct oral challenge (DOC), penicillin skin testing (PST) plus DOC, or direct de-labeling based on PEN-FAST scoring. Sixty-three patients were screened, and 32 (50.8%) underwent full reconciliation. Among FAR patients, the median PEN-FAST score was 0, and 25 (78.1%) underwent DOC. De-labeling was successful in 28 FAR patients (87.5%). One patient (4%) experienced a mild reaction. Allergy field updates occurred in 69.8% of screened and 96.9% of FAR patients. Antibiotic optimization occurred in 12 FAR patients, saving 78 days of therapy. Estimated cost savings totaled $37,632. PADLS effectively and safely de-labeled PCN allergies, resulting in improved antimicrobial selection, and could generate cost savings, supporting broader implementation of pharmacist-led allergy stewardship programs.
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