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Penicillin Allergy – The use of analytics in de labelling

Up to 95% of patients labelled with a penicillin allergy do not have a true penicillin allergy and this has significant effect on their access to appropriate treatment for infections.

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  • Idea
  • 2022

Meet the team


  • Dr Rebecca Sutherland - Infectious Diseases Consultant NHS Lothian
  • Victoria Mullholland - Nurse Consultant for Unscheduled Care NHS Lothian
  • Emma Savory - Project Admin support SDEC WGH NHS Lothian

What is the challenge your project is going to address and how does it connect to the theme?

The Scottish Antimicrobial Prescribing Group (SAPG) supported by the Healthcare Improvement Agency have a penicillin de labelling toolkit to support assessing and challenging inappropriate penicillin allergy labels.

The Same Day Emergency Care Unit (SDEC) in the WGH in Edinburgh have been deploying the SAPG protocol to support the de-labelling of patients who are undergoing admission to hospital for antibiotics as a consequence of their penicillin allergy.

There is a significant volume of patients within the community with a penicillin allergy who are not being challenged at present but represent a Tsunami of complex antimicrobial decisions as this population ages and requires antimicrobial treatments associated with infection and hospital admission.

We hope to offer an increased access to penicillin de-labelling within the SDEC environment for screened low risk patients.

We require some infrastructure support to develop our EPR and analytics to standardize and integrate QI methodology to scale effect.

What does your project aim to achieve?

1. A training program – using online vimeo instructions and a clinical toolkit linked to the SAPG resources to increase use of penicillin de labelling within the acute medicine and SDEC environment. These can be used by all clinical care teams.

2. Implement EPR specific data capture with integrated analytics to fuel further local BI and funding stream bids to scale and increase activity

3.Embed clinical safety – ensuring that EPR labelling is unpicked by the challenge and that patients retain the ability to access penicillin based antibiotics after successful challenge.

4. Parity of access for all patients to ensure that the label of penicillin allergy they have is accurate and not creating harm by preventing access to appropriate antibiotics.

How is your project going to share learning?

1. Development of key tools to train and challenge patients with a penicillin allergy. This would be ideal to link to the eLearning for health platform and the SAPG website – to further develop the current tools to support clinical challenge.

2. Share the toolkits via the Society of Acute Medicine &  Royal Colleges of Physicians.

3. Aim to publish toolkits and learning associated with this to national and international conferences with open source toolkit access for free use across the globe.

4. Sharing our passion and commitment to data driven healthcare through regular twitter posts and perhaps aim to run data explorer training session to innovate the local healthcare environment to standardise the data intelligence focus needed to create precision medicine.

How you can contribute

  • 1. Skills and expertise links to good video and graphic designer for quality of information shared. Some of this may be accessible via the Scottish Tech Army (STA) - we will explore paid and free volunteer resources to maintain costs as low as is possible.
  • 2. Sounding boards for when we hit barriers
  • 3. Critical analysis of plans - to feel as though the content has merit and is worthy when reviewed by peers.

Plan timeline

1 Dec 2022


  1. Hi Rachel,

    I have a personal interest in this and think it could be really helpful in reducing the burden caused by inappropriate labelling. Interested in how the learning might be shared and in particular the potential role of the Q community in this.

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