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Optimizing Penicillin Allergy Delabeling: One Big Step Forward and Several Small Steps Sideways

      It is now widely accepted that all individuals with a reported penicillin allergy should be evaluated, and, if the history is appropriate, tested to confirm current clinically significant immunologically mediated hypersensitivity or tolerance.
      • Shenoy E.S.
      • Macy E.
      • Rowe T.
      • Blumenthal K.G.
      Evaluation and management of penicillin allergy: a review.
      Direct oral challenges are now widely used in penicillin allergy delabeling of low-risk individuals, but questions remain as to what constitutes low risk, what is the optimal oral challenge protocol, how penicillin skin testing should be performed and with what reagents, and exactly what is the current role for penicillin skin testing.
      • Torres M.J.
      • Adkinson Jr., N.F.
      • Caubet J.C.
      • Khan D.A.
      • Kidon M.I.
      • Mendelson L.
      • et al.
      AAAAI/WAO 2018 Symposium Penicillin and Cephalosporin Allergy Testing Working Group. Controversies in drug allergy: beta-latam hypersensitivity testing.
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