PEN-FAST
From IDWiki
Background
- Clinical decision rule to help with delabelling penicillin allergy
- Used to predict the results of penicillin allergy testing (skin prick testing, intradermal testing, patch testing, or oral challenge)
Criteria
| Criterion | Details | Points |
|---|---|---|
| Five or fewer years ago | 2 | |
| Anaphylaxis or angioedema, or
Severe adverse cutaneous reaction (SCAR) |
includes AGEP, DRESS, SJS, and TEN | 2 |
| Treatment required for allergy episode | 1 |
Interpretation
| Interpretation | Points | Probability of Positive Skin Testing |
|---|---|---|
| Very low risk | 0 | 0.6% |
| Low risk | 1-2 | 5% |
| Moderate risk | 3 | 20% |
| High risk | 4-5 | 50% |
- A score less than 3 has been used as a cutoff
Further Reading
- Development and Validation of a Penicillin Allergy Clinical Decision Rule. JAMA Internal Med. 2020;180(5):745-752. doi: 10.1001/jamainternmed.2020.0403
