In addition, the more recently published guidelines favor proceeding to DOC without PST in adults with low-risk penicillin allergy histories, and utilizing PST primarily for patients with a history of anaphylaxis or a recent reaction suspected to be IgE-mediated (eg, immediate onset urticaria).5 If this pilot was repeated with this updated approach, it is likely that more patients would have been captured and delabeled. Here, IGHE is linked to anaphylaxis.