Table 3. Institutional and personnel requirements for medically supervised exposure to β-lactam antibiotics in the case of reported β-lactam antibiotic allergy.

– Observation by healthcare professionals for at least 60 minutes after each dose increase (e.g., after administration of 10 or 100% of a single therapeutic dose), depending on the risk, under inpatient or outpatient conditions. Observation by non-medical personnel is not sufficient.

– There must be a doctor in close proximity for immediate intervention.

– In case of risk of moderate or severe immediate reaction, rapid availability of anesthesia emergency team or allergist experienced in anaphylaxis therapy

– Staff trained in dealing with anaphylactic reactions

– Availability of suitable emergency therapy equipment

– Consent of the persons to be treated and/or legal guardians (example see Figure 5)

– Informing the treated persons and/or guardians about what to do if a reaction occurs after the end of medical supervision