Low-risk penicillin allergy delabeling: a scoping review of direct oral challenge practice, implementation, and multi-disciplinary approaches

Expert Rev Anti Infect Ther. 2023 Dec 14. doi: 10.1080/14787210.2023.2296068. Online ahead of print.ABSTRACTINTRODUCTION: Penicillin allergy is common and there is increased clinician interest in direct oral challenge (DOC) as a testing strategy for low-risk penicillin allergy. To aid wider implementation of DOC, consensus definitions of low-risk penicillin allergy phenotypes, and standardized approaches to assessment, DOC procedures and evaluation, are required.AREAS COVERED: This review systematically reviews studies that have utilized penicillin DOC in healthcare settings to identify heterogeneity in implementation approaches and synthesize low-risk definitions, procedures, and evaluation.EXPERT OPINION: Opportunity exists to standardize penicillin DOC procedures in patients with a low-risk penicillin allergy to optimize antimicrobial prescribing and reduce the burden of penicillin allergy. Standardising the definitions of 'low-risk' and 'positive challenge,' and improving the evaluation of patient safety, alongside the development of a unified approach to the structure of undertaking an oral challenge, is likely to increase uptake and confidence among non-allergist clinicians.PMID:38098185 | DOI:10.1080/14787210.2023.2296068

Source: Expert Review of Anti-Infective Therapy - December 15, 2023 Category: Infectious Diseases Authors: Elise Mitri Gemma Reynolds Catherine J Hornung Jason A Trubiano Source Type: research