AUTHOR=Sunagawa Shawnalyn W. , Bergman Scott J. , Kreikemeier Emily , Watkins Andrew B. , Alexander Bryan T. , Miller Molly M. , Schroeder Danny , Stohs Erica J. , Van Schooneveld Trevor C. , May Sara M. TITLE=Use of a beta-lactam graded challenge process for inpatients with self-reported penicillin allergies at an academic medical center JOURNAL=Frontiers in Allergy VOLUME=Volume 4 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2023.1161683 DOI=10.3389/falgy.2023.1161683 ISSN=2673-6101 ABSTRACT=Contribution to the field: Penicillin allergies are one of the most frequently reported drug allergies. Choosing optimal antimicrobial therapy in the hospital for patients with self-reported penicillin allergies can be difficult, especially in situations where the preferred therapy is a beta-lactam agent. A recent guidance update for management of patients with antimicrobial allergies placed greater emphasis on de-labeling antimicrobial allergies and utilizing direct drug challenges. This article describes the real-world implementation, hospital utilization, and assessment of safety for both oral and intravenously administered beta-lactam drug challenges in low-risk patients with self-reported penicillin allergies at an academic medical center without a formal allergy consult service. The results of this evaluation demonstrate the safety and feasibility of conducting these drug challenges on inpatients.