Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22925
Title: Children with reported penicillin allergy: Public health impact and safety of delabeling.
Austin Authors: Vyles, David;Antoon, James W;Norton, Allison;Stone, Cosby A;Trubiano, Jason ;Radowicz, Alexandra;Phillips, Elizabeth J
Affiliation: Department of Pediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Centre for Antibiotic Allergy and Research, Austin Health, Heidelberg, Victoria, Australia
Department of Pediatric and Adolescent Medicine, Children's Hospital, University of Illinois Hospital & Health Sciences System, Chicago, Illinois; Division of Hospital Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee; The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
Department of Pediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Issue Date: Jun-2020
Date: 2020-03-26
Publication information: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2020; 124(6): 558-565
Abstract: To review the relevant literature related to children with reported penicillin allergy and highlight the different ways in which children could be delabeled and to evaluate the public health impact that a penicillin allergy has for children. Data for this review were obtained via PubMed searches and then retrieval of articles from their respective journals for further review. Studies regarding the safety of different ways to evaluate penicillin allergy in children were identified via PubMed searches. Any study that reported different ways of testing (3-tier, direct oral challenge, 5-day oral challenges) were included. This same format was used when selecting relevant articles related to the costs, prescription patterns, and stewardship trends associated with a penicillin allergy label. This review found that penicillin allergy testing is a safe and effective way to delabel those with reported allergy. In children with low-risk allergy symptoms, a direct oral challenge approach may be optimal. In those children with a history of high-risk allergy symptoms, a 3-tiered approach is ideal. The review also found that there is a significant cost associated with reported penicillin allergy and that there are increased negative health benefits to those children with reported allergy. Penicillin allergy is overdiagnosed, often incorrectly, and the label is frequently first applied during childhood. Targeting children for the removal of the incorrect penicillin allergy label provides a mechanism to reduce the use of broader-spectrum and less effective antibiotics.
URI: https://ahro.austin.org.au/austinjspui/handle/1/22925
DOI: 10.1016/j.anai.2020.03.012
ORCID: 0000-0002-5111-6367
Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
PubMed URL: 32224207
Type: Journal Article
Appears in Collections:Journal articles

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