Is direct oral amoxicillin challenge a viable approach for 'low-risk' patients labelled with penicillin allergy?

Krishna, Mamidipudi T and Misbah, Siraj A (2019) Is direct oral amoxicillin challenge a viable approach for 'low-risk' patients labelled with penicillin allergy? The Journal of antimicrobial chemotherapy. ISSN 1460-2091. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

Spurious penicillin allergy (PenA) is a major public health problem. Up to 10% of the population and 20% of inpatients are labelled with PenA, but only <5%-10% have a proven allergy following comprehensive investigations. PenA tests are labour intensive and require specialist input, which may not be readily available due to limited allergy services. Therefore, patients with PenA receive alternative antibiotics that are associated with higher rates of iatrogenic infections, antimicrobial resistance and a longer hospital stay with consequent increased costs. Recent evidence suggests that a supervised 'direct' oral amoxicillin challenge (without performing allergy tests) is a safe option in low-risk patients (those least likely to be allergic based on history). Patient selection for this procedure is based on a careful guideline-based risk stratification process. Further research is needed to validate this intervention in routine clinical practice and explore potential facilitators and barriers to implementation in different healthcare settings.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QV Pharmacology
WD Diseases and disorders of systemic, metabolic or environmental origin > WD300 Hypersensitivity. Allergy
Divisions: Clinical Support
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Depositing User: Mrs Yolande Brookes
Date Deposited: 07 Jun 2019 11:50
Last Modified: 07 Jun 2019 12:01
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/2143

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