Penicillin Allergy Delabeling in Children

The Penicillin Allergy Delabeling in Children study, funded by the Jefferson Pediatric Award for Clinical Research, will address penicillin allergy labeling in pediatric primary care both from the provider and parent perspectives.

The aims of the study are to:

  1. Describe primary care provider perspectives of reported penicillin allergies and attitudes towards recommended penicillin allergy delabeling in children.
  2. Examine parental knowledge of penicillin allergy labels and attitudes towards penicillin allergy delabeling. 

An estimated 5 million children have a reported allergy to penicillin, yet over 90% of these children who undergo penicillin allergy testing can safely tolerate penicillin. Reported penicillin allergies in children result in the use of broad-spectrum antibiotics that are costlier, less-effective, increase children’s risk for adverse drug events, and prolong hospital stays. The proactive removal of falsely or incompletely reported penicillin allergies (i.e., penicillin allergy delabeling) is recommended by leading allergy societies including the American Academy of Allergy, Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology (ACAAI), but the practice is rarely performed among pediatric primary care physicians. In addition, poor parental engagement presents barriers to erroneous penicillin allergy removal. Although previous research has shown that antibiotic prescribing differs by race/ethnicity, there is paucity of data on racial and ethnic differences in parental and provider attitudes towards delabeling; a gap in knowledge that will be addressed in this study. Research is needed to better understand barriers and facilitators to penicillin allergy delabeling and oral challenges in primary care that are amenable to intervention from both the provider and parent/guardian perspective.

Monika Pogorzelska-Maziarz, PhD, MPH, CIC, FAPIC, FSHEA
Co-Principal Investigator
Jefferson College of Nursing 

Sharon L. Hwang, MD
Co-Principal Investigator
Nemours Children’s Health

Mary Lou Manning, PhD, CRNP, CIC, FAPIC, FSHEA, FAAN
Jefferson College of Nursing 

Eileen J. Carter, PhD, RN
University of Connecticut College of Nursing 

Elizabeth Monsees, PhD, MBA, RN, CIC, FAPIC
Children’s Mercy – Kansas City 

Tara Schmidt, BS
Clinical Research Assistant
Jefferson College of Nursing

Which providers are eligible to participate?

Primary care practices have been identified through collaboration/affiliation with Nemours Children’s Health – Delaware Valley, Children’s Mercy – Kansas City and Connecticut Children’s Clinically Integrated Network. Providers from invited practices are eligible to participate if they provide primary care to children in their practice.  

What is involved in participation?

A member of our study team will conduct in-depth, telephone interviews or focus groups with primary care providers from one of the three study sites. We anticipate that each interview will last between 45 to 60 minutes. Each interview will be conducted one‐on‐one, and will be audiotaped for transcription purposes. All data will be confidential, and no practice or individual will be identified in any report.

What are the benefits of participation?

While there is no direct benefit to your practice, we understand your time is valuable. Therefore, we will provide an honorarium of $100 per participant in the form of a gift card. This honorarium will be given either directly to the participant or the practice, based on institutional policy/preference.

Next steps and who should I contact if I have additional questions?

To discuss participation and confirm eligibility, we can schedule a short informational call at a time that is convenient for you. If you are eligible to participate, we will schedule the telephone interview at times that are convenient for you. For further information, please contact the research team

Who is eligible to participate?

Parents of children with a penicillin allergy are eligible to participate if their child is receiving care at a practice invited to participate in the study.

What is involved in participation?

Participation involves completing the study questionnaire, which takes approximately 10-20 minutes. The questionnaire is available online and is available in both English and Spanish. All data will be confidential, and no individual will be identified in any report. Once we receive your completed questionnaire, you will be entered into a lottery for an Apple iPad, as a thank you! 6 iPads total will be available.

What are the benefits of participation?

The goal of this study is to improve our understanding of what parents think about allergy testing and labeling for their children. From the study results, we want to improve how doctors and parents work together to get the right information about penicillin allergies for children. This will lead to better and safer healthcare for kids who might actually be able to use penicillin without any problems. While you may not personally benefit from participating, the knowledge we gain from the study will help other parents like you around the country.

Who should I contact if I have additional questions?

If you have questions, please contact us at