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Penicillin Relabeling Rate After Drug Allergy Assessment
Patient reported penicillin allergy leads to higher healthcare costs, increased risk of bacterial resistance, and suboptimal antibiotic treatment. Penicillin testing to ‘delabel’ patients has helped address these effects, though despite negative testing some patients are later relabeled, or in some cases never delabeled.
Source: Journal of Allergy and Clinical Immunology - February 1, 2023 Category: Allergy & Immunology Authors: Edsel Abud, Courtney Ramos, Kevin Cook Source Type: research

A Quality Improvement Initiative to Increase Access to Penicillin Allergy Evaluations in Pediatric Surgical Patients
Surgical patients with a penicillin allergy label have worse clinical outcomes and increased healthcare costs compared to patients without a penicillin allergy label. Our aim is to decrease the number of pediatric patients presenting to surgery with a penicillin allergy label by increasing access to pre-operative penicillin allergy evaluation.
Source: Journal of Allergy and Clinical Immunology - February 1, 2023 Category: Allergy & Immunology Authors: Ann Hefel, Laura Ann Wang, Carolyn Foley, Maureen Bauer, GeeMei Tan, Patrick Fernandez, Rachel Burns Source Type: research

Persistent Penicillin Allergy Label in Pharmacies after Penicillin Allergy De-labeling
Carrying a penicillin allergy label is associated with increased healthcare costs and adverse events. De-labeling a penicillin allergy can optimize antimicrobial stewardship and improve patient care.
Source: Journal of Allergy and Clinical Immunology - February 1, 2023 Category: Allergy & Immunology Authors: Althea Marie Diaz, Luz Fonacier, Heather Stern, Stephanie Mawhirt, Erin Banta, Sonam Sani Source Type: research

De-labeling Beta-lactam in Adult Population
AbstractPurpose of reviewThis review summarizes the various strategies used to de-label adults who are considered to be allergic to beta-lactams and focuses on areas for improvement.Recent findingsStrategies for de-labeling penicillin allergy are based on the direct challenge, the classical drug allergy work-up, and stratification of a risk of allergic reaction after exposure to beta-lactams. Strategies based on direct ingestion of aminopenicillin without previous skin tests are safe in low-risk patients. The classical allergy work-up with skin tests and drug provocation has been used for cases where immediate reaction (ur...
Source: Current Treatment Options in Allergy - July 30, 2022 Category: Allergy & Immunology Source Type: research

Needlessly Avoiding Meropenem Use In Hospitalized Patients
The administration of meropenem in hospitalized patients is restricted when a suspected penicillin allergy is present. This leads to the use of second-line treatments that increase the risk of antibiotic resistances and healthcare costs. We aimed to study the utility of a bedside meropenem allergy workout in these patients.
Source: Journal of Allergy and Clinical Immunology - February 1, 2021 Category: Allergy & Immunology Authors: L. Marin, M.J. Pe ñalver, B. Moya, J.F. Crespo, R. Mielgo Source Type: research

The role of a clinical pharmacist in spurious Penicillin allergy: a narrative review
Conclusion Direct oral penicillin challenge reduces the adverse impact of spurious penicillin allergy. A pharmacist-led penicillin allergy de-labelling program needs further validation in prospective multi-centre studies.
Source: International Journal of Clinical Pharmacy - January 13, 2021 Category: Drugs & Pharmacology Source Type: research

β‐Lactam allergy testing and delabeling—Experiences and lessons from Singapore
ConclusionDrug allergy testing was safe and removed inappropriate labels.Clinical ImplicationAllergy testing is efficacious, but fears of subsequent rechallenge should be addressed to maximize the effectiveness of allergy delabeling.
Source: Immunity, Inflammation and Disease - June 6, 2020 Category: Allergy & Immunology Authors: Yee Kiat Heng, Yasmin Chia Chia Liew, Yan Ling Kong, Yen Loo Lim Tags: ORIGINAL RESEARCH Source Type: research

Ruling out penicillin allergy at a university hospital: proof of concept.
Reported penicillin allergy results in excessive antibiotic use, complications, and cost. We hypothesized that a protocol evaluating penicillin allergy in the inpatients with skin prick testing, intradermal testing and graded oral challenge to amoxicillin would reduce excessive antibiotics, complications, and healthcare costs.
Source: Journal of Allergy and Clinical Immunology - January 31, 2020 Category: Allergy & Immunology Authors: Levi Keller, Matthew Miller, Misha Huang, Nichole Neville, Taylor Morrisette, Anjeli Kalra Source Type: research

The impact of maternal penicillin allergy on neonatal care and health care cost
Less effective antibiotics are often administered to pregnant women with reported penicillin allergy and group B streptococcus (GBS) colonization, which results in additional testing and increased observation time of the neonatal population. We suspect that healthcare costs and length of stay is thereby increased in neonates of mothers who report penicillin allergy.
Source: Journal of Allergy and Clinical Immunology - January 31, 2020 Category: Allergy & Immunology Authors: Dustin Fowler, Susan Evenhouse, Corinne Corrigan, Claire MacGeorge, Annie Andrews, Genevieve Hayes, Kelli Williams Source Type: research

Impact of a Penicillin Allergy Educational Session on Clinical Practice
Documented penicillin allergy results in altered antibiotic regimens for patients, leading to increased side effects, antibiotic resistance, and increased healthcare costs. Penicillin allergy is commonly listed in the medical record, but the likelihood of IgE-mediated allergic reactions is low. We hypothesized that an educational session on penicillin allergy for Internal Medicine residents would improve knowledge and likelihood of recommending penicillin allergy evaluation.
Source: Journal of Allergy and Clinical Immunology - January 31, 2020 Category: Allergy & Immunology Authors: Lauren Kaminsky, Gisoo Ghaffari, Ami DeWaters Source Type: research

A Retrospective Critical Analysis and Risk Stratification of Penicillin Allergy De-labelling in a UK Specialist Regional Allergy Service
ConclusionSystematic clinical characterisation and risk stratification has an important role in Pen-A de-labelling. These data provide proof of concept for a guideline-based selection of patients labelled with Pen-A for a direct penicillin challenge. Patients in the ‘low risk’ group seem suitable for this intervention, although a rigorous prospective evaluation is needed in a multi-centre study.
Source: The Journal of Allergy and Clinical Immunology: In Practice - July 5, 2018 Category: Allergy & Immunology Source Type: research

Outpatient penicillin skin testing has greater value in targeted patient populations
β-Lactam allergy is a major component of antimicrobial stewardship today due to its reported associations with increased healthcare costs, drug toxicity, infections with drug-resistant bacteria, and use of less-preferred antibiotic therapies.1,2 It remains the most common reported medication allerg y in the United States, with an estimated prevalence of 10%.1 The US Centers for Disease Control and Prevention and the Infectious Disease Society of America, among other institutions, recommend the performance of penicillin skin testing (PST) as part of antimicrobial stewardship.
Source: Annals of Allergy, Asthma and Immunology - April 1, 2018 Category: Allergy & Immunology Authors: Viviana M. Temi ño, Timothy P. Gauthier, Paola Lichtenberger Source Type: research

Documentation of Penicillin Adverse Drug Reactions in Electronic Health Records: Inconsistent Use of Allergy and Intolerance Labels
ConclusionThe frequency of penicillin allergy label in this dataset is consistent with the known overdiagnosis of penicillin allergy in the hospital population. ADR documentation was poor with incomplete entries and inconsistent categorisation. The concepts of allergy and intolerance for ADR classification, whilst mechanistically valid, may not be useful at the point of ADR entry by generalist clinicians. Systematic evaluation of reported ADRs is needed to improve the quality of information for future prescribers.
Source: Internal Medicine Journal - July 1, 2017 Category: Internal Medicine Authors: Joshua M. Inglis, Gillian E. Caughey, William Smith, Sepehr Shakib Tags: Original Article Source Type: research