Penicillin allergy delabeling in a German University Hospital-implementation in inpatient settings: the…

StudyInfection· Aug 2026

Penicillin allergy delabeling in a German University Hospital-implementation in inpatient settings: the PenGuin Pilot Study.

Hannah Nürnberg, Katrin Hörth, Kristin Egenberger … Elham Khatamzas

Allergy & ImmunologyStudyClinical practiceQ1IF 3.5

One-third of eligible penicillin-allergy inpatients were successfully delabeled during hospitalization.

Penicillin allergy delabeling in a German University Hospital-implementation in inpatient settings: the PenGuin Pilot Study.

Hannah Nürnberg … Elham Khatamzas

Infection · Aug 2026 · Q1 in General Medicine

Background

Penicillin allergy (penicillin allergy) is reported in up to 15% of hospitalized patients, although true IgE-mediated hypersensitivity is rare.

Methods

This prospective implementation study was conducted on four wards of a 2600-bed German tertiary care center.

n = 2890 screened patients

33.3%

Results

33.3%

one in three inpatients with a penicillin-allergy label had it removed

n = 2890 screened patients

More results

Among 2890 screened patients, 179 (6.2%) reported a penicillin allergy.

Direct oral challenge was well tolerated, with only one mild skin reaction observed.

Ward-specific environments influenced the use of different delabeling strategies.

More results

Follow-up showed limited transfer of delabeling outcomes to primary care, reducing long-term sustainability.

“

Conclusion · 1 of 2

Pharmacist-led penicillin allergy delabeling can be safely integrated and is feasible within existing clinical workflows. However, real-world implementation barriers and incomplete transfer to primary care limited its full potential.

Conclusion · 2 of 2

Improve standardized documentation and cross-sector communication are important for sustainable and widespread implementation of delabeling strategies.

Penicillin allergy delabeling in a German University Hospital-implementation in inpatient settings: the PenGuin Pilot Study.

Penicillin allergy delabeling in a German University Hospital-implementation in inpatient settings: the PenGuin Pilot Study.

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