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Macy E (2014) Penicillin and beta-lactam allergy: epidemiology and diagnosis. Shenoy ES, Macy E, Rowe T, Blumenthal KG (2019) Evaluation and management of penicillin allergy: a review. Joint Commission on Hospital Accreditation (2016) APPROVED: new antimicrobial stewardship standard. This article reviews delabeling strategies utilized by these programs with a focus on highlighting elements key to their success and future areas for innovation. Delabeling programs have been successful in the inpatient and outpatient settings at enabling appropriate antibiotic use. These populations include perioperative, prenatal, and immunocompromised patients. This review also focuses on delabeling programs for high-risk populations likely to benefit from first-line β-lactam antibiotics. β-Lactam delabeling programs for inpatients, pediatric patients, and programs utilizing telehealth have been implemented with good outcomes. This review provides an overview of current risk stratification methods and β-lactam cross-reactivity data and summarizes how different inpatient and outpatient delabeling programs have used these concepts in delabeling algorithms. ![]() Recent programs have targeted patients thought to be most likely to benefit from removal of inaccurate antibiotic allergy labels, those with β-lactam antibiotic allergies and high-risk populations likely to need β-lactam antibiotics as first-line treatment. Development of delabeling programs involves careful selection of target patient population, thoughtful design of delabeling approach, stakeholder engagement, assembly of key team members, implementation, and evaluation of clinical and safety outcomes. Drug allergy delabeling programs have become an essential element of antibiotic stewardship.
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