# Describing Self-Reported Penicillin Allergy Using a Penicillin Allergy Risk Tool (PEN-FAST) in an Outpatient Setting at a Tertiary Hospital in Saudi Arabia

## TL;DR

This study used the PEN-FAST tool to assess self-reported penicillin allergies in Saudi Arabia, finding most were not severe and many were likely misclassified.

## Contribution

The study evaluates the PEN-FAST tool's effectiveness in identifying true penicillin allergies in a Saudi outpatient setting.

## Key findings

- Only 4% of participants reported a penicillin allergy, with most symptoms being mild like nausea and itching.
- PEN-FAST categorized 83.3% of self-reported allergies as low or very low risk for a true penicillin allergy.
- Only one participant was confirmed allergic via skin prick test, suggesting many self-reported allergies are not true allergies.

## Abstract

Introduction

Penicillin is a widely used antibiotic and is frequently reported as a cause of allergic reactions. However, many individuals reporting penicillin allergies are later found to be tolerant. This study, conducted in an outpatient setting at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia, aimed to assess the prevalence of self-reported penicillin allergy and to evaluate further the risk of a positive penicillin allergy test using the PEN-FAST tool.

Methods

A cross-sectional study was conducted via in-person questionnaires with patients in the waiting area at the outpatient clinics of KAUH in Jeddah, Saudi Arabia.

Results

Among 140 participants, 4% reported a penicillin allergy, with most identifying their allergies based on symptoms. None of these allergies resulted in severe reactions. Notably, 50% reported nausea and itching as symptoms. The PEN-FAST tool categorized 33.3% as moderate risk and 50% as low to very low risk for a positive penicillin skin test. One participant was confirmed to be allergic via a skin prick test.

Discussion and conclusion

The prevalence of reported penicillin allergy was lower in our study than that previously reported. Evaluation of the PEN-FAST score demonstrated that this prevalence is even lower at 2%. While this single-center study offers valuable insights, further research in diverse healthcare settings is required to validate these findings and refine our understanding of penicillin allergies.