Guidelines for the management of adult penicillin allergy in community and specialist settings in Australia and New Zealand: An AGREE II and Delphi-based approach
Year: 2026
Type: article
Abstract: Background: This guideline was developed in collaboration with the Australasian Society of Clinical Immunology and Allergy (ASCIA), the National Allergy Council and the National Allergy Centre of Excellence (NACE). Despite the abundance of published penicillin allergy guidelines, few have been developed using rigorous evidence-based approaches such as the AGREE II framework. Objective: This guideline aims to provide recommendations for the assessment and management of adults with a penicillin allergy label, for Australian health professionals working in both community and specialist settings. Methods: The guideline was developed using the standardized, evidence-based AGREE II framework, consumer input, and a Delphi-based consensus process, involving a multidisciplinary panel of 27 drug allergy experts. Recommendations were informed by a rapid overview of reviews and existing guidelines. Results: A total of 37 recommendations reached consensus, covering risk stratification, testing protocols, challenge test outcomes, and communication and documentation process. Conclusions: These adult guidelines will support the implementation of penicillin allergy delabeling programs in community and specialist centers in Australia. As high-level evidence supporting many recommendations in this field remains limited, a Delphi-based expert consensus approach provides valuable guidance.
Authors: Michaela Lucas, Jillian Kehoe, Samantha Stiles, Sandra M. Salter, Jacqueline Loprete, Catherine J. Hornung, Lara Martin, Syed B. Ali, Rani Scott Farmer, Joseph DeLuca, Suran Fernando, Constance Katelaris, Helen Kolawole, Jason Trubiano, Kirsten P. Perrett, William Smith, Francis Thien, Jennifer J. Koplin, Sandra Vale, James Yun
Institutions: The University of Western Australia, Princess Margaret Hospital for Children, Sir Charles Gairdner Hospital, Pathwest Laboratory Medicine, Perth Children's Hospital, Australasian Society of Clinical Immunology and Allergy, Murdoch Children's Research Institute, UNSW Sydney, St Vincent's Hospital Sydney, The University of Queensland, Flinders Medical Centre, Austin Health, The University of Sydney, Royal North Shore Hospital, NSW Health Pathology, Camden and Campbelltown Hospitals, Western Sydney University, Monash University, Royal Children's Hospital, The University of Melbourne, Royal Adelaide Hospital, Box Hill Hospital, Prince of Wales Hospital
Language: English
Subfield: Pharmacology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
Funders: AstraZeneca, Australasian Society of Clinical Immunology and Allergy, Children’s Hospital of Wisconsin Research Institute, Murdoch Children's Research Institute, Australian Government, Mylan, Department of Health and Aged Care, Australian Government, State Government of Victoria, Swedish Orphan Biovitrum, CSL Limited, Seqirus
OpenAlex ID: W7204591596