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RATIONALE: A public health imperative exists to de-label patients of penicillin allergy, however there is lack of consensus on testing procedures and reporting and the effectiveness of testing programs is uncertain. METHODS: A survey to assess variation in penicillin allergy practice was distributed by the AAAAI email portal to active members. The impact of years in practice and type of practice was assessed by chi-squared tests. RESULTS: The survey was undertaken by 15% (652/4,330) of allergists from across the United States. 90% of respondents reported performing skin testing (ST) to beta lactaThose in practice <10 years were more likely to offer oral challenge (OC) following ST (93% vs. 85%, p50.01). Providers offering ST and OC were more likely to advise patients they could safely take all beta-lactams (36% vs. 21%, p50.04), whereas those offering ST only more likely advised beta-lactam use on a risk-benefit basis (30% vs 16%, p5 0.02). Academic practitioners more commonly tested to minor determinant mixture (44% vs 36%, p5 0.09). Pre-Pen was reported overall as the most prevalent ST positive (66% of responses), however 15% of providers who tested for ampicillin reported it as the most prevalent positive. Only 24% of practitioners were confident that primary care providers received and/or followed recommendations. CONCLUSIONS: Significant variability in penicillin allergy testing practices exists that may negatively impact its effectiveness. This suggests a need for the re-evaluation and standardization of current beta-lactam allergy practice parameters. J ALLERGY CLIN IMMUNOL FEBRUARY 2015 AB386 AbstractsReproduced with permission of the copyright owner. Further reproduction prohibited without permission.

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