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

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

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

Consider referral if:

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

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 .

Educational content only. Always verify information and use clinical judgement.