Low risk patients: Direct de-labelling based on clinical history assessment

SAPG has updated its penicillin allergy de-labelling pathway to support removal of inaccurate penicillin allergy labels and improve access to appropriate antibiotic treatment. 

This page contains resources for patients assessed as low risk using the using the Penicillin Allergy De-Labelling (PADL) Algorithm.  

More information on how to set up and run a PADL service can be found in the protocol for implementation of penicillin allergy de-labelling in adult patients in acute hospitals. 

There is also a guide containing frequently asked questions for clinicians completing PADL.

Additional resources available for de-labelling low risk patients:   

• PADL algorithm.
• Penicillin allergy information sheet.
• Patient post-assessment information: No penicillin allergy.
• GP post-assessment letter: No penicillin allergy.

For more information on penicillin allergy de-labelling, refer to the pages below:

• Penicillin allergy de-labelling.
• Patients identified as medium risk on the PADL algorithm.
• Patients identified as high risk on the PADL algorithm.
• Full list of PADL resources.   

These are available to adapt for local use in Scotland. Outside Scotland, Attribution-NonCommercial (CC BY-NC) applies.  

Scottish Antimicrobial Prescribing Group (SAPG) | August 2026 for review Aug 2029

Content update October 2026