Betalactam hypersensitivity: The importance of delabelling in primary care.

The aim of the present study was to assess the outcomes of an allergy work up of patients with a penicillin allergy label by primary care. Patients and methods An allergy work up was performed on adult patients with a history of a penicillin allergy seen by primary medical care in Monastir (Tunisia) between July 2016 and February 2018. Patients with negative skin tests (ST) were challenged with amoxicillin. Patients who were delabeled were subsequently contacted by phone in six months to determine outcomes after any therapeutic penicillin-class antibiotic intake. Results A total of 39 patients were evaluated and 33 (84.6%) were delabeled. Five patients were penicillin skin test positive and one was oral challenge positive. We succeeded in contacting 33 delabeled patients at six months. Twenty two patients had tolerated a subsequent therapeutic course of amoxicillin, eight patients did not retook a penicillin due to a lack of therapeutic indication, and three patients refused an indicated penicillin use fearful of another reaction. Conclusion We highlights the importance of allergy work up in the diagnosis of beta-lactam hypersensitivity. Most patients were excessively labeled as beta-lactam allergic and this mislabeling could increase the health care costs and leads to the development of drug resistance by the use of wide spectrum antibiotics.