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Antibiotic allergy de-labeling in the intensive care unit: The prospective ADE-ICU study.
J Crit Care
February 2025
Department of Anaesthesiology, Intensive Care and Pain Medicine, St. James's Hospital, Dublin, Ireland; Trinity College Dublin, Dublin, Ireland. Electronic address:
Purpose: Critically ill patients in the intensive care unit (ICU) are frequently prescribed antibiotics, with many reporting an antibiotic allergy label, predominantly to penicillin. Mislabeling contributes to suboptimal antibiotic use, increasing multidrug-resistant organisms and Clostridium difficile infections, and increased hospital length of stay. This prospective study implemented an antibiotic allergy assessment and testing program in the ICU, independently of clinical immunology/allergy services.
View Article and Find Full Text PDFNot Just an Oxymoron: The Utilitarian's Guide to Antimicrobial Stewardship in Transplant Infectious Diseases.
Transpl Infect Dis
December 2024
Division of Infectious Disease and Tropical Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.
Solid organ transplant and hematopoietic cell transplant patients face an increased risk of infectious diseases, greater exposure to antibiotics, and heightened risk of multidrug-resistant organisms (MDROs) due to their immunosuppressed state. Antimicrobial stewardship programs (ASP) are essential in reducing the incidence of MDRO by conserving antimicrobial use, minimizing treatment durations, and improving the appropriate use of diagnostic testing. However, the role of ASP in transplant infectious diseases (TID) is still evolving, necessitating greater collaboration between ASP and transplant programs.
View Article and Find Full Text PDFReliability and validation of an electronic penicillin allergy risk-assessment tool in a pregnant population.
Allergy Asthma Clin Immunol
October 2024
Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Article Synopsis
- Penicillin allergies often lead to unnecessary treatment delays, as many reported allergies are not true allergies; efficient tools are needed to identify low-risk patients for safe de-labeling.
- The FIRSTLINE electronic decision support tool was implemented to help clinicians assess and stratify penicillin allergy risk among pregnant women in Vancouver, with a focus on its reliability compared to allergist evaluations and other tools like JAMA and PENFAST.
- Results showed that 97.2% of 181 patients were not allergic, and FIRSTLINE effectively identified a high percentage of low-risk patients, emphasizing the value of clinical algorithms in improving patient care.
Risk Stratification of Penicillin Allergy Labeled Children: A Cross-Sectional Study from Jordan.
Ther Clin Risk Manag
August 2024
Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Background: Implementing allergy testing among children with a reported history of penicillin allergy could be challenging, particularly in developing countries with limited resources. This study screened and risk-stratified the likelihood of true penicillin allergy among children labeled with penicillin allergy in Jordan.
Methods: A web-based survey, completed by parents, assessed history, type, and severity of penicillin allergic reactions, including age at diagnosis, symptoms, time to the reaction, reaction's course and resolution, and received medical evaluation/testing.
Leveraging implementation science theories to develop and expand the use of a penicillin allergy de-labeling intervention.
BMC Health Serv Res
August 2024
William S. Middleton Veterans Memorial Hospital Madison, Madison, WI, USA.
Background: Penicillin allergy is the most frequently reported drug allergy, yet most patients can tolerate the drug if challenged. Despite this discrepancy, large scale penicillin allergy de-labeling interventions have not been widely implemented in many health care systems. The application of a multi-method implementation science approach can provide key tools to study this evidence to practice gap and provide insight to successfully operationalize penicillin allergy evaluation in real-world clinical settings.
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