| Recommendation | Strength | Quality of evidence |
| 1. We recommend that in patients with a suspected immediate type allergy to penicillins, irrespective of severity, that occurred ≤ 5 years ago, all other penicillins should be avoided*. | Strong | Low |
| 2. We recommend that in patients with a suspected* non-severe immediate type allergy to penicillins, that occurred >5 years ago, all other penicillins can be used in a controlled setting**. | Strong | Low |
| 3. We suggest that in patients with suspected non-severe delayed type allergy to penicillins that occurred ≤1 year ago, all other penicillins should be avoided*. | Weak | Low |
| 4. We suggest that in patients with a suspected non-severe delayed type allergy to penicillins that occurred >1 year ago, all other penicillins can be used*. | Weak | Low |
| 5. We recommend that in patients with suspected severe delayed type allergy (see "Indeling type allergie") to penicillins, all other penicillins should be avoided, irrespective of time since the index reaction. In the absence of acceptable alternative antimicrobial treatment, the use of penicillins should be discussed in a multidisciplinary team***. | Strong | GPS |
* In case of a proven allergy by formal allergy work up, handle according to the advice of the consulted allergist.
** A clinical setting, in which the patient is observed, with trained personnel, where rapid and adequate treatment can be administered when an allergic reaction occurs.
*** An expert team that consists of an infectious diseases specialist and/ or microbiologist, pharmacist and if available an allergist. The risk of side effects and benefits of use of proper antibiotic should be balanced against each other followed by shared decision making with the patient.
Bron: SWAB guideline for the approach to suspected Antibiotic Allergy, 2022. Richtlijn downloaden: 192 (swab.nl)