Widening access to penicillin allergy assessment in the United Kingdom - a proposed implementation plan for the National Health Service (NHS)

Sep 30, 2026

Uploaded by Connor

Incorrect penicillin allergy labels increasingly harm patient outcomes by driving broader non-penicillin antibiotic use, contributing to treatment failures, and accelerating antimicrobial resistance. The work highlights that many millions of patients worldwide carry incorrect labels, yet specialist capacity is limited and point-of-care testing is scarce. Evidence from UK studies (SPACE and ALABAMA), shaped with patient and stakeholder input, supports an implementation plan to widen access to assessment across the NHS. It outlines responsibilities and key actions for safe delivery.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Aims

Problem of incorrect penicillin allergy labels in health records

JAC Antimicrob Resist [https://doi.org/10.1093/jacamr/dlaf240](https://doi.org/10.1093/jacamr/dlaf240) JACAntimicrobial Resistance Widening access to penicillin allergy assessment in the United Kingdom—a proposed implementation plan for the National Health Service (NHS) Catherine E. Porter 1, Caity Roleston2, Claire Bethune3, Jenny Boards4, Colin S. Brown5,6, Ian Clarke7, Joanne Fielding1, Philip Howard 8,9, Conor Jamieson10, Siraj A. Misbah11, Andrew C. Moss12†, Sue H. Pavitt1, Neil Powell 13, Louise Savic14, Sinisa Savic 15,16, Mamidipudi Thirumala Krishna17,18, Sarah Tonkin-Crine 2,6, Iestyn Williams 19 and Jonathan A.T. Sandoe 20,21* 1Dental Translational and Clinical Research Unit, School of Dentistry, University of Leeds, Leeds, UK; 2Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; 3Peninsula Immunology and Allergy Service, University Hospitals Plymouth NHS Trust, Plymouth, UK; 4PPIE Contributor, Dental Translational and Clinical Research Unit, part of the NIHR Leeds Clinical Research Facility, School of Dentistry, University of Leeds, Leeds, UK; 5Antimicrobial Resistance & Healthcare-Associated Infections Division, UK Health Security Agency, London, UK; 6NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance (NIHR200915), University of Oxford, Oxford, UK; 7PPIE Contributor; 8Regional Antimicrobial Stewardship Lead, NHS England, North-East and Yorkshire, Newcastle, UK; 9School of Healthcare, University of Leeds, Leeds, UK; 10Medical Directorate, NHS England (Midlands), Birmingham, UK; 11Department of Clinical Immunology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; 12Egton Medical Information Systems Limited (t/a Optum), Fulford Grange, Micklefield Lane, Rawdon, Leeds, UK; 13Pharmacy Department, Royal Cornwall Hospitals NHS Trust, Truro, Cornwall, UK; 14Department of Anaesthesia, Leeds Teaching Hospitals NHS Trust, Leeds, UK; 15Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; 16Department of Clinical Immunology and Allergy, St James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK; 17Department of Immunology and Immunotherapy, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK; 18Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 19Health Services Management Centre, University of Birmingham, Edgbaston, Birmingham, UK; 20Healthcare Associated Infection Group, Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK; 21Department of Medical Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK *Corresponding author. E-mail: [J.Sandoe@leeds.ac.uk](J.Sandoe@leeds.ac.uk) †Former affiliation at the time the work was carried out. Globally, there is increasing evidence that incorrect penicillin allergy labels negatively affect patient outcomes, antibiotic prescribing and antimicrobial resistance, leading to growing concern about this patient safety issue and how to resolve it. While many millions of patients worldwide have incorrect penicillin allergy labels, there are too few specialist allergists and a lack of ‘point-of-care’ tests to address this problem. Numerous research studies now provide evidence of the feasibility and importance of widening access to penicillin allergy assessment. Researchers from two UK-based studies (SPACE and ALABAMA), in collaboration with key stakeholders including patient representatives, gave their views to shape a high-level implementation plan to facilitate widening access to penicillin allergy assessment in the UK. This Viewpoint describes the basis ofthe implementation plan and summarizes the key actions required for successful delivery. While the plan is intended for the UK, we hope to promote international shared learning and collaboration to address this global problem

FAQs

Why are incorrect penicillin allergy labels a patient safety concern?

Incorrect labels lead to unnecessary use of non-penicillin antibiotics and are associated with treatment failures and more antimicrobial resistance.

What evidence supports widening access to penicillin allergy assessment?

Research from UK studies (SPACE and ALABAMA), informed by stakeholder input, supports the feasibility and importance of expanding access to assessment.

What does the proposed implementation plan aim to do in the NHS?

It sets out what needs to happen to enable wider access to penicillin allergy assessment, including assigning responsibilities and defining where they should sit within the health system.

Sep 30, 2026

Uploaded by Connor