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Results Of the 1738 files reviewed, 172 contained a notion of alleged penicillin allergy. History of the reaction to penicillin was poorly detailed even when patients required beta-lactam therapy (table 1). In the 87 patients who did require a beta-lactam, half received it without any skin testing, challenge or desensitization. No adverse reaction occurred. The main antibiotics used in the remaining patients were fluoroquinolones and vancomycin. Decision-making concerning the choice of antibiotic was documented in only 18%. Upon discharge, only two patients were referred to an allergy clinic for elective penicillin skin testing, even though referral was strongly indicated in 97 patients (table 2). Conclusion Penicillin allergy is a frequent problem in hospital practice. Its management is not optimal in most cases. This study stresses the importance of continuous medical education on this subject and the importance of a readily available inpatient allergy service to support hospital practitioners.

Quality of penicillin allergy management in the intensive care unit and internal medicine ward