SAFETY PEN – Safe, feasible and effective transitioning of allergy assessment for penicillins to community care

SAFETY-PEN project at Sir Charles Gairdner Hospital (SCGH) is piloting a GP-led service for testing and delabelling low-risk penicillin allergies with an oral challenge in your general practice. This initiative seeks to provide a safe, practical, and cost-effective alternative to the conventional model, serving communities both in metropolitan and remote areas of Western Australia.

Penicillin is the cornerstone of antibiotic therapy but is frequently underused due to the reported allergies that affect about 10 per cent of the population. Surprisingly, research reveals that over 90 per cent of these reported allergies are inaccurately diagnosed.

This mislabelling often leads to the use of alternative antibiotics, which can be less effective, more costly, and increase the risk of antibiotic resistance. Patients burdened with incorrect antibiotic allergy labels experience poorer health outcomes and increased economic costs. This may also increase consultation times with doctors while second-line antibiotics are sought, along with severe shortages of the commonly used alternatives.

Traditionally, allergy assessments and delabelling have been conducted in outpatient clinics within tertiary hospitals, which are not readily accessible to everyone, particularly those in rural and remote areas. Our current systems are overstretched, resulting in extended wait times and prioritisation of only urgent or high-risk cases.

There is also a lack of studies on the feasibility and effectiveness of conducting these assessments in community settings despite research widely proving non-allergy specialists can safely delabel low-risk penicillin allergy labels via a direct oral challenge with a very low rate of adverse events.

We are inviting general practices to participate in this pilot program to collaborate with hospital specialists to address and resolve false low-risk penicillin allergy labels.

Participating health professionals will receive education and training, enabling them to collaborate within a shared care system with direct access to the SCGH Immunology department.

Educational materials are being developed in conjunction with the RACGP and will be designed to count towards CPD learning and audit requirements.

After the training, you will be equipped to assess low-risk penicillin allergy labels using a standardised protocol. Compensation will be provided for the time you dedicate to this study.

By joining us, you will play a crucial role in reducing the community burden of inappropriate penicillin allergy labels, simplifying patient care, and mitigating the long-term health and economic impacts associated with mislabeled allergies.

For more information or to express interest in participating, contact Dr Rishabh Kulkarni, Immunology Service Registrar, SCGH via rish.kulkarni@research.uwa.edu.au or phone 0410 755 076.