Around 2.8 million Australians report the label

Up to nine in 10 Australians with a reported penicillin allergy are not allergic when properly assessed, according to research cited by the National Allergy Council.

Around 10% of people report a penicillin allergy. Based on the estimated resident population of 27,921,150 at 31 March 2026, that is approximately 2.8 million Australians. Fewer than 1% of the population are thought to be truly allergic.

The National Allergy Council is encouraging Australians who have been told they are allergic to penicillin to discuss it with their doctor and consider whether an old allergy record is worth revisiting.

The awareness campaign coincides with the release of new ASCIA guidelines developed in collaboration with the National Allergy Centre of Excellence. Together with online training and resources, the guidelines support General Practitioners and other health professionals to assess and manage reported penicillin allergy, including identifying people who may be suitable for penicillin allergy assessment by their GP.

The National Allergy Council is a partnership between the Australasian Society of Clinical Immunology and Allergy and Allergy & Anaphylaxis Australia, Australia’s peak medical and patient support organisations for allergic disease.

Funding from the Australian Government Department of Health, Disability and Ageing enables the National Allergy Council, alongside ASCIA and Allergy & Anaphylaxis Australia, to deliver evidence-based public health initiatives, education, training and support in consultation with key stakeholders, to improve the health and wellbeing of people with allergic disease. Anaphylaxis Australia, to deliver evidence-based public health initiatives, education, training and support in consultation with key stakeholders, to improve the health and wellbeing of people with allergic disease.

Professor Michaela Lucas, a Clinical Immunology/Allergy Specialist and Co-chair of the National Allergy Council’s Drug Allergy Working Group, said: “For many people, a penicillin allergy recorded after symptoms experienced during a childhood illness has followed them throughout their lives. We want people to understand that an allergy recorded years or even decades ago may be worth reassessing, rather than assuming they will always be allergic to penicillin.”

Lucas said there were several reasons why someone may have penicillin recorded as an allergy when they are not currently allergic.

“Someone may have developed a rash while taking penicillin and understandably it was assumed the antibiotic was responsible, when the rash may actually have been caused by the underlying illness or another factor,” Professor Lucas said.

She said people should not disregard a suspected allergy or try penicillin themselves, and should instead talk to a doctor about whether proper investigation may be appropriate.

“The range of penicillin medications are often the preferred treatment for bacterial infections. If penicillin is recorded as an allergy, doctors need to prescribe alternative antibiotics, so knowing whether a patient is truly allergic means doctors can make the most appropriate treatment choice,” Professor Lucas said.

Reported antibiotic allergy is also associated with longer treatment and hospital stays, higher readmission rates and greater use of alternative antibiotics. Unnecessary use of alternative antibiotics can contribute to antimicrobial resistance, where bacteria become resistant to antibiotics.

GPs assess low-risk cases

Ms Maria Said AM, Director and Co-Chair of the National Allergy Council, said people who have been avoiding penicillin for years may find out whether they are truly allergic more easily than they realise.

The first step, she said, is to talk to a GP, who can review medical history, symptoms and how long ago the reaction occurred, then decide whether further assessment may be appropriate.

Dr Nick Cooling, a GP and Chair of the RACGP Specific Interest Group in Allergy, said the new guidelines would give GPs clearer guidance on assessing people with a reported penicillin allergy and identifying those who may be suitable for removing a penicillin allergy label in general practice.

For some people considered at low risk of a serious allergic reaction, this may involve an oral penicillin challenge under medical supervision. The antibiotic is given in a medical setting, and you are closely monitored in case an allergic reaction happens, with the process generally taking around two hours. People that are not found to be allergic to penicillin then have an increased range of antibiotics to target specific infections.

People with a history suggesting a higher risk of penicillin allergy may need further testing and assessment by a specialist allergy service. No one should try taking penicillin themselves to find out whether they are allergic. Antibiotics should only be taken when prescribed for the individual taking them.

More than 90% of people recorded as having a penicillin allergy can tolerate penicillin following appropriate assessment and testing.

Around 50% of people with a positive penicillin skin test lose that reactivity within five years, while around 80% of people with a true immediate penicillin allergy become tolerant after 10 years.

In Western Australian hospitals, up to 10% of children have a recorded antibiotic allergy, along with 18% of adult inpatients. Penicillin accounts for 79% of recorded antibiotic allergies in children in Western Australian hospitals and 71% in adults.

An Australian economic evaluation found that, compared with usual care, low-risk inpatients who underwent penicillin allergy assessment and had the allergy removed had an average 4.41 fewer hospital days and $9,467.72 lower hospital costs per patient. The study was exploratory.

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