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Position Paper

Recommendations on how to proceed in case of suspected allergy to penicillin/β-lactam antibiotics. Position paper of the German Society for Allergology and Clinical Immunology (DGAKI) in cooperation with the German Society for Pediatric Allergology (

Knut Brockow, Wolfgang Pfützner, Bettina Wedi, Gerda Wurpts, Axel Trautmann, Burkhard Kreft, Timo Buhl, Mathias Sulk, Andreas Recke, Kathrin Scherer, Stefan Wöhrl, Irena Neustädter, Regina Treudler, Christiane Querbach, and Margitta Worm

Volume 9 (2025) p. 28 - 39

Abstract

Allergologie select, Vol. 9/2025 (28-39)

Knut Brockow¹, Wolfgang Pfützner², Bettina Wedi³, Gerda Wurpts⁴, Axel Trautmann⁵, Burkhard Kreft⁶, Timo Buhl⁷, Mathias Sulk⁸, Andreas Recke⁹, Kathrin Scherer¹⁰, Stefan Wöhrl¹¹, Irena Neustädter¹², Regina Treudler¹³, Christiane Querbach¹⁴, and Margitta Worm¹⁵

¹Department of Dermatology and Allergology Biederstein, Faculty of Medicine and Health, Technical University of Munich, Munich, ²Department of Dermatology and Allergology, University Hospital Giessen and Marburg, Marburg, ³Hanover Medical School, Department of Dermatology, Allergology and Venereology, Hanover, ⁴Department of Dermatology and Allergology, Germany, Aachen Comprehensive Allergy Center (ACAC), University Hospital of RWTH Aachen University, Aachen, ⁵Department of Dermatology and Allergology, Allergy Center Mainfranken, University Hospital Würzburg, Würzburg, ⁶Department of Dermatology and Venereology, University Hospital Halle, Halle (Saale), ⁷Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, ⁸Department of Dermatology, Münster University Hospital, Münster, ⁹Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Holstein Campus Lübeck, Lübeck, Germany, ¹⁰Department of Dermatology, Cantonal Hospital Aarau, Aarau, and Department of Dermatology and Allergology, University Hospital Basel, Switzerland, ¹¹Floridsdorf Allergy Center (FAZ), Vienna, Austria, ¹²Pediatric Clinic, Diakoneo Klinik Hallerwiese-Cnopfsche Kinderklinik, Nuremberg, ¹³Institute for Allergy Research, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, ¹⁴Hospital Pharmacy, Klinikum rechts der Isar, Technical University of Munich, Munich, and ¹⁵Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
β-lactam antibiotics (BLAs) are still the antibiotics of first choice for the treatment of many bacterial infections. Treatment with a BLA is often hindered by a suspected allergy, up to 10% of the population report an allergy to penicillin. After Position Paper allergological evaluation of the suspected allergic reaction to a BLA, most patients show a low probability of a BLA allergy; only in a minority of cases an allergic reaction to the repeated administration of a BLA appear likely in view of the previous history. In > 90% of cases, the suspected BLA allergy can be ruled out by allergy diagnostics. We recommend a risk-stratified approach in the context of an urgent need for BLA, which should enable most patients to receive a BLA therapy. After acute therapy, allergy diagnostics have to be done to clearly prove or reliably rule out a BLA allergy.Correspondence to:
Prof. Dr. med. Knut Brockow, Department of Dermatology and Allergology Biederstein, Faculty of Medicine and Health, Technical University of Munich, Biedersteiner Strasse 29, 80802 Munich, Germany
Email: [email protected]

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