Check Again Network (Penicillin Allergy de-labelling)

About the project

The Check Again Network aims to ensure Victorians have access to safe and suitable antibiotics. This will be done by starting or improving programs to assess and test penicillin allergies in hospitals across Victoria.

Objectives

• Spread and scale penicillin allergy assessment and testing across Victorian hospitals.
• Improve access to essential antibiotics to improve outcomes and reduce harm.
• Ensure more consistent care for patients. 

Background

Over 2 million Australians say they are allergic to an antibiotic, with one in 10 patients in hospitals reporting to have a penicillin allergy.

However, research shows that more than 95% of these penicillin allergy labels are wrong.

Having an allergy to antibiotics can lead to:

• using less effective antibiotics
• more hospital readmissions
• more infections after surgery
• longer stays in the hospital.

Accurately assessing and recording penicillin allergies is important. This has been recognised by the Australian Commission on Safety and Quality in Health Care (ACSQHC) Antimicrobial Stewardship (AMS) Clinical Care Standards as a key component of AMS programs.

How to get involved

From July 2026, the Check Again Network will transition to Austin Health and continue as the National Antibiotic Allergy Network (NAAN) Collaborative.

To find out more or show your interest in joining, please email NAAN@austin.org.au or visit the National Antibiotic Allergy Network (NAAN) Collaborative.

Solution design

Check Again reassesses penicillin allergies through: 

• a standardised, evidence-based approach that can be adopted by both large and small health services
• in-hospital testing to see whether a patient can safely take penicillin
• testing during a patient’s hospital stay, reducing the need for outpatient follow-up and saving time for patients and clinicians
• a statewide toolkit, learning modules and a practical guide to help clinicians apply best practice (see key resources). The project has built strong engagement with rural and regional hospitals, enabling high quality, equitable care across the state.

The intervention design is a Network Model and draws on the analysis and feedback from the previous “Check Again Collaborative” and is underpinned by data from the International Network of Antibiotic Allergy Nations (iNAAN).

Our impact so far

• More than 3,700 patients have had their penicillin allergy safely reassessed. That’s 3,900 people who can now confidently receive the best treatment when they need it most.
• More than 1,700 patients were tested during their hospital stay, resulting in fewer follow-up visits and saving time, travel and leave from work or caregiving responsibilities. It’s not just happening in city hospitals. 

Regional health services (such as Mildura Base Public Hospital and East Grampians Health Service) are embracing the program, ensuring that high-quality care is possible no matter your postcode. By improving access to safe and effective antibiotics, Check Again is:

• improving the accuracy of allergy records
• supporting better antibiotic prescribing practices
• reducing the risk of side effects and hospital-acquired complications
• making penicillin allergy management more equitable across Victoria.

Key resources

Penicillin Allergy Assessment and Direct Oral Challenge

This document provides a standardised approach for clinicians on assessing penicillin allergies and undertaking direct oral penicillin challenges for hospitalised Victorians with a low-risk penicillin allergy.

Learning module – Check Again

This learning module is designed to enhance healthcare clinician understanding and management of antibiotic allergies. It provides a structured, interactive approach to equip learners with the skills to assess and act on antibiotic allergies (specifically penicillin allergies) appropriately.

Adult penicillin allergy programmes in Australian hospitals: a practical guide from the National Antibiotic Allergy Network

The National Antibiotic Allergy Network has developed a guide to support clinicians when implementing penicillin allergy programs — particularly direct oral challenge protocols — within Australian hospitals.

Executive summary – Check Again Collaborative Evaluation Report

This report evaluates the Check Again Collaborative, highlighting key findings, lessons learned, and recommendations for improving antimicrobial allergy management in Australian hospitals.

Toolkit – Check Again

This resource is for services that are planning improvement work to improve the assessment of penicillin allergies and implement delabelling strategies for low-risk penicillin allergies.

Change package – Check Again

The Check Again change package supports participants in a Breakthrough Series Collaborative to start/improve penicillin allergy assessment and testing within their health services.