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Allergy to Beta Lactam Evaluation (ABLE)

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While penicillin antibiotics are one of the most common medication allergies in the United States, nearly 90% of people who report a penicillin allergy do not have a true IgE mediated allergic reaction. This misconception results in using non-preferred antibiotics, leading to antimicrobial resistance and treatment failure.

The Allergy to Beta Lactam Evaluation (ABLE) initiative consists of a standardized template and note title for pharmacists to effectively and efficiently evaluate and clarify patient penicillin allergies. The ABLE template guides the pharmacist through the allergy history to provide recommendations on alternative beta lactam use. In some cases, the ABLE template can facilitate penicillin allergy removal, also known as de-labeling. Although not all allergies can be removed using the ABLE template alone, the ABLE template does provide guidance on further penicillin allergy testing recommendations, if appropriate for the patient.

Along with the template, the ABLE initiative provides opportunities to implement a penicillin skin testing clinic and/or an inpatient amoxicillin oral drug challenge program for low-risk allergies.

For more information on how to implement this practice at your VA, please visit https://dvagov.sharepoint.com/sites/VHAClinicalPharmacy/SitePages/Allergy-to-Beta-Lactam-Evaluation-(ABLE).aspx.

This innovation is scaling widely with the support of national stakeholders. See more scaling innovations.


November 2016, Memphis VA Medical Center


2 successful, 13 in-progress

Awards and Recognition:

Tennessee Pharmacist Association Innovative Pharmacist of the Year , iNET Spread Investee, VHA Shark Tank Winner



  • An in-house cost avoidance assessment was performed circa 2018. We estimate approximately $1200 saved by each successful assessment.