Polypharmacy Guidance: appropriate prescribing, making medicines safe, effective and sustainable 2025 - 2028
9. Antibiotics and penicillin allergy
Antibiotics
The decision to start or not start antibiotic therapy, requires careful consideration as there are potential side-effects, which may add to the symptom burden at end-of-life.
- Antibiotics may be indicated to relieve symptoms or potentially cure an infection at the end-of-life.
- Risks and benefits should be considered including when treatment would require hospitalisation.
Penicillin allergy
Approximately 10% of people identify as having a penicillin allergy, however true penicillin allergy is estimated to affect only one percent of the population.
- It is essential that individuals who have a potentially incorrect penicillin allergy label are fully assessed to confirm if they are truly allergic or not.
- For people who do not have a true penicillin allergy, it may be possible to consider supervised penicillin allergy de-labelling (PADL) oral challenge. PADL may be undertaken in a hospital setting after careful assessment of risk.