Effects of Interventions for Delabeling Penicillin Allergy in Hospitalized Patients: A Systematic Review

Background and objective: Penicillin allergy labels are common among hospitalized patients, yet most represent inaccurate or nonimmune-mediated reactions and may contribute to suboptimal antibiotic prescribing. This systematic review aimed to evaluate the effectiveness and safety of hospital-based penicillin allergy delabeling interventions and their impact on antibiotic prescribing.

Methods

PubMed/MEDLINE, CENTRAL, Scopus, and Web of Science were systematically searched up to January 2026. Additional records were identified through ClinicalTrials.gov and citation tracking. Eligible studies included hospitalized patients with documented penicillin or β-lactam allergy labels who underwent structured delabeling interventions with a comparator group. Given substantial heterogeneity in study design, interventions, and outcomes, findings were synthesized narratively.