Allergies to first-line antibiotics complicate care, and use of broad-spectrum alternatives is associated with prolonged hospital stays and increased rates of admissions to ICU. It also makes emergence of antimicrobial-resistant pathogens more likely. Ten to 16% of adult patients are marked in the record as being allergic to penicillins but the majority of these labels are applied inaccurately or have become outdated over time. While skin-prick testing is a safe and reliable way to delabel patients who can tolerate penicillin, it is resource-intensive and requires trained allergists on-site. In this podcast we describe a decision tool called PEN-FAST that helps to quickly identify patients suitable for direct oral challenge in almost any setting. Guests include two of the leading academics behind the validation and scale-up of this algorithm. GuestsProfessor Jason Trubiano FRACP FAAAAI‍ (Austin Health, Director of Infectious Diseases; Peter Doherty Institute for Infection and Immunity) Prof Suran Fernando FRACP FRCPA PhD OAM (recent!) (Royal North Shore Hospital; University of Sydney) Dr Fionnuala Fagan FRACP FRCPA (Dunedin Hospital; Otago University) Chapters10:42 PEN-FAST tool 22:23 Multi-site testing of PEN-FAST 28:27 Non allergist-led testing 32:42 System-wide outcomesProductionProduction by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘The Bayou’ and ‘Feels like I’m going Crazy’ by Tigerblood Jewel. Feedback on this episode kindly provided by Dr Marion Leighton, Dr Robin Sia, Dr Aidan Tan, Dr Hugh Murray, Arnika Martus and Paul Cooper PhD. Image courtesy of Thirteen of Clubs at Flickr.Visit the Pomegranate Health web page for a transcript and supporting references. Add educational activity to MyCPD. Subscribe through any podcasting app or our email alerts list.

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