Table 1.

Overview of the included studies.

Authors	Title	Country, Setting	Year	Design	Research Aim	Population
Al-Ahmad, M. & Rodriguez-Bouza, T. [12]	Drug allergy evaluation for beta-lactam hypersensitivity: Cross-reactivity with cephalosporins, carbapenems, and negative predictive value	Kuwait, tertiary public allergy centre	2017	Telephone survey	To evaluate subsequent beta-lactam use following a negative test	40 patients who had a negative penicillin allergy test
Amin, W., et al. [13] [Conference abstract]	A clinical audit on reporting and documentation of penicillin allergy at an NHS Foundation Trust Hospital	U.K., general hospital	2010	Questionnaire	To examine patients’ and professionals’ perceptions and knowledge regarding penicillin allergic reactions	30 hospital clinicians
Andres, B. et al. [14] [Conference abstract]	Suspected allergy to beta-lactam antibiotic: The value of diagnostic evaluation	Spain, Allergy Department	2013	Telephone survey	To assess the number of patients with confirmed beta-lactam allergy, drugs involved in reactions, and the usefulness of the diagnostic tests	40 patients who had a negative penicillin allergy test
Blumenthal, K.G. et al. [15]	Effect of a drug allergy educational program and antibiotic prescribing guideline on inpatient clinical providers’ antibiotic prescribing knowledge	U.S., tertiary care facility	2014	Questionnaire	To survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with penicillin allergy	258 inpatient providers from neurology, paediatrics, internal medicine, orthopaedic surgery, general surgery, attending hospital physicians, and nurse practitioners
Cohen, S. et al. [16] [Conference abstract]	The real use of beta-lactams after “penicillin allergic” label removal	Israel, allergy clinic	2012	Telephone questionnaire	To assess patients’ confidence in their allergy test results and whether they have taken penicillin since testing	106 patients who had a negative penicillin allergy test
Elkhalifa, S. et al. [17] [Conference abstract]	Management of patients with a history of penicillin allergy: Barriers to best practice and strategies to overcome them	U.K., general hospital	2017	Email survey	To investigate prescribers’ knowledge of penicillin allergy diagnosis and management and their views about the barriers to correct management	164 hospital doctors including doctors in training, consultants, and non-medical prescribers
Eriksson, M. et al. [18] [Conference abstract]	Are patients prone to using penicillin after testing negative for penicillin allergy at a specialist centre?	Sweden, allergy clinic	2017	Questionnaire	To assess, if tested negatively for penicillin allergy, patients’ attitude to future penicillin treatment	103 patients who had a negative penicillin allergy test
Gerace, K. & Phillips, E. [19]	Penicillin allergy label persists despite negative testing	U.S., allergy clinic	2015	Email or telephone survey	To elucidate patient interpretation of their results and antibiotic utilisation after penicillin allergy testing (PAT)	42 patients who underwent PAT
Grillo, J. A. & Le, T.V. [20] [Conference abstract]	An assessment of current practice and knowledge of penicillin allergy at hospital-based paediatric centres	U.S., hospital-based centres	2015	Online survey	To assess current knowledge of clinicians and management of penicillin allergy	Inpatient paediatric providers at hospital-based centres
Hayoun, M.B. et al. [21]	The impact of allergy to beta-lactam antibiotics on general practitioners and patients in a cohort of 154 French patients	France, primary care	2015	Telephone questionnaire	To evaluate the role of the general practitioner (GP) in the management of allergy to Beta Lactams, and to analyse the interpretation of the allergological assessment by the GPs or patients themselves	80 GPs and 26 patients (when GP not available)
Jose, J. & Ishmael, F. T. [22] [Conference abstract]	A drug allergy education handout is an easy and effective method to improve patient awareness of penicillin allergy and increase penicillin testing	U.S., allergy clinic	2017	Survey	To assess patients’ prior knowledge of penicillin allergy and whether they were interested in being allergy tested	67 patients who attended a general allergy clinic
Phillips, E. J. et al. [23] [Conference abstract]	The Utility of Penicillin Skin Testing in a Tertiary Care Clinic	Canada, Drug Safety Clinic	2002	Telephone survey	To determine how the information provided from penicillin skin testing affects beta-lactam antibiotic use or patient attitudes towards future use of beta-lactam antibiotics	348 patients who had a negative penicillin allergy test
Picard, M. et al. [24]	Treatment of Patients with a History of Penicillin Allergy in a Large Tertiary-Care Academic Hospital	Canada, general hospital	2013	Survey	To assess allergy referral habits for patients with a history of penicillin allergy	44 attending physicians
Ratzon, R. et al., [25]	Impact of an extended challenge on the effectiveness of beta-lactam hypersensitivity investigation	Israel, medical centre	2016	Survey	To evaluate the effectiveness of a 7-day Drug Provocation Test (DPT) and a 1-day (short) DPT for beta-lactam allergy	49 patients who had a negative penicillin allergy test
Semedo, F.M. [26] [Conference abstract]	Full course drug provocation tests to penicillins—do we really need them?	Portugal, not known	2017	Survey	To evaluate diagnosis of penicillin allergy	54 patients who had a negative penicillin allergy test
Soni, D. et al. [27] [Conference abstract]	A clinical perspective: the prescribers’ true understanding of the penicillin-allergic patient	U.S., not known	2016	Survey	To survey knowledge of inpatient providers from different specialties regarding penicillin allergy	121 inpatients providers
Staicu, M.L. et al. [28]	A survey of inpatient practitioner knowledge of penicillin allergy at 2 community teaching hospitals	U.S., community-based teaching hospitals	2017	Online survey	To describe health care practitioner behaviour and identify potential knowledge gaps pertinent to the management of the penicillin-allergic patient	276 healthcare practitioners including attending physicians, advanced practice practitioners, pharmacists, and residents
Suetrong, N. & Klaewsongkram, J. [29]	The Differences and Similarities between Allergists and Non-Allergists for Penicillin Allergy Management	Thailand	2014	Email survey	To assess knowledge of penicillin allergy skin testing and attitudes towards the management of patients with a history of penicillin allergy	205 physicians including general practitioners, internists, paediatricians, allergists
Sundquist, B. K. et al. [30]	Proactive penicillin allergy testing in primary care patients labelled as allergic: outcomes and barriers	U.S., academic Internal Medicine practice	2017	Telephone survey (patients); Online survey (general practitioners)	To determine patient satisfaction with PAT to determine barriers to referring patients to testing	31 patients who had a negative penicillin allergy test 7 primary care clinicians who referred patients to the study
Trubiano, J. A. [31]	Improving Antimicrobial Stewardship by Antibiotic Allergy Delabelling: Evaluation of Knowledge, Attitude, and Practices Throughout the Emerging Infections Network	U.S. and Canada, the Emerging Infections Network	2016	Email survey	To assess receptiveness for incorporating antibiotic allergy testing in hospitals	736 active members of the Emerging Infections Network clinicians: Adult and paediatric Infectious Disease physicians
Warrington, R. J. et al. [32]	The value of skin testing for penicillin allergy in an inpatient population: analysis of the subsequent patient management.	Canada, allergy clinic	2000	Telephone survey	To assess why antibiotics were not taken after a negative skin test for penicillin allergy	84 patients who had a negative penicillin allergy skin test