When should I refer a patient with a history of drug hypersensitivity to a specialist for further evaluation?

Refer a patient with a history of drug hypersensitivity to a specialist drug allergy service if they have experienced:

• a suspected anaphylactic reaction to any drug ¹
• a severe non-immediate cutaneous reaction such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens–Johnson Syndrome, or toxic epidermal necrolysis ¹
• a suspected allergic reaction to a non-steroidal anti-inflammatory drug (NSAID) with symptoms like anaphylaxis, severe angioedema, or an asthmatic reaction ¹
• a suspected allergy to beta-lactam antibiotics when they need treatment with these antibiotics or are likely to require them frequently in the future ¹
• an inability to undergo a procedure involving a local anaesthetic due to suspected allergy ¹
• anaphylaxis or another suspected allergic reaction during or immediately after general anaesthesia ¹

Consider referral if:

• the patient cannot take beta-lactam antibiotics and at least one other antibiotic class due to suspected allergies ¹

In all cases, document the suspected drug allergy in the medical records, stop the suspected drug, treat acute symptoms if needed, and provide the patient with information about their allergy ¹.