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The Global Prevalence of Reported Penicillin Allergy: A Systematic Review and Meta-Analysis.
J Infect
January 2025
Department of Infectious diseases- Faculty of Medicine, Imperial College London.
Objectives: Patients labelled with penicillin allergy (PenA) often receive broader spectrum antibiotics, associated with antimicrobial resistance and poorer outcomes. However, ~95% of patients are likely mis-labelled. Whilst de-labelling programmes are gaining momentum, they have been restricted to a few countries.
View Article and Find Full Text PDFCharacteristics, risk factors and clinical impact of penicillin and other antibiotic allergies in adults in the UK General Practice: A population-based cohort study.
J Infect
January 2025
Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong.
Objective: To assess the characteristics, risk factors and clinical impact of penicillin and other antibiotic allergy labels in general practice in the UK.
Design: Population-based cohort study.
Setting: Primary care in the UK, 2000-2018.
Developing and disseminating an electronic penicillin allergy de-labelling tool using the model for improvement framework.
Allergy Asthma Clin Immunol
December 2024
BC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada.
Background: Many clinicians feel uncomfortable with de-labelling penicillin allergies despite ample safety data. Point of care tools effectively support providers with de-labelling. This study's objective was to increase the number of providers intending to pursue a penicillin oral challenge by 15% by February 2023.
View Article and Find Full Text PDFUtilising primary care electronic health records to deliver the ALABAMA randomised controlled trial of penicillin allergy assessment.
Trials
October 2024
Leeds Institute of Medical Research, University of Leeds, Leeds, UK.
Background: Use of electronic health records (EHR) to provide real-world data for research is established, but using EHR to deliver randomised controlled trials (RCTs) more efficiently is less developed. The Allergy AntiBiotics And Microbial resistAnce (ALABAMA) RCT evaluated a penicillin allergy assessment pathway versus usual clinical care in a UK primary care setting. The aim of this paper is to describe how EHRs were used to facilitate efficient delivery of a large-scale randomised trial of a complex intervention embracing efficient participant identification, supporting minimising GP workload, providing accurate post-intervention EHR updates of allergy status, and facilitating participant follow up and outcome data collection.
View Article and Find Full Text PDFFactors influencing implementation and adoption of direct oral penicillin challenge for allergy delabelling: a qualitative evaluation.
BMJ Open Qual
September 2024
Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Background: Over 95% of penicillin allergy labels are inaccurate and may be addressed in low-risk patients using direct oral penicillin challenge (DPC). This study explored the behaviour, attitudes and acceptability of patients, healthcare professionals (HCPs) and managers of using DPC in low-risk patients.
Methods: Mixed-method, investigation involving patient interviews and staff focus groups at three NHS acute hospitals.
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