Evaluating the PEN-FAST Clinical Decision-making Tool to Enhance Penicillin Allergy Delabeling
Chang Su, MD1; Ami Belmont, MD1; Jane Liao, MD1; et al John K. Kuster, MD1; Jason A. Trubiano, MBBS, PhD2; Jason H. Kwah, MD, MSc1
Author Affiliations
JAMA Intern Med. 2023;183(8):883-885. doi:10.1001/jamainternmed.2023.1572
Patient-reported penicillin allergy is associated with inappropriate prescribing, antibiotic resistance, and adverse outcomes.1 Various clinical decision-making tools for penicillin allergy have been developed to guide antibiotic selection and delabeling strategies,1-3 yet further validation is required to promote their use. PEN-FAST is a clinical decision-making tool with a high negative predictive value (NPV) that can identify patients with low-risk penicillin allergy who do not require skin testing prior to oral penicillin challenge.1 We aimed to validate PEN-FAST in risk stratification of reported penicillin allergies at a large tertiary health care system outside of the country in which it was developed to further promote PEN-FAST use and enhance global penicillin allergy delabeling.