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Title: The Challenge of De-labeling Penicillin Allergy.
Austin Authors: Stone, Cosby A;Trubiano, Jason A ;Coleman, David T;Rukasin, Christine R F;Phillips, Elizabeth J
Affiliation: Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, Western Australia, 6150
Department of Pharmacology, Vanderbilt University School of Medicine
Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Department of Infectious Diseases and Centre for Antibiotic Allergy and Research, Peter MacCallum Cancer Centre, Melbourne, VIC AUS
Medicine (University of Melbourne)
The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Parkville, VIC, AUS
Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Centre for Antibiotic Allergy and Research
Issue Date: Feb-2020 2019-05-02
Publication information: Allergy 2020; 75(2): 273-288
Abstract: Even though 8-25% of most populations studied globally are labeled as penicillin allergic, most diagnoses of penicillin allergy are made in childhood and relate to events that are either not allergic in nature, are low-risk for immediate hypersensitivity, or are a potential true allergy that has waned over time. Penicillin allergy labels directly impact antimicrobial stewardship by leading to use of less effective and broader spectrum antimicrobials and are associated with antimicrobial resistance. They may also delay appropriate antimicrobial therapy, and lead to increased risk of specific adverse healthcare outcomes. Operationalizing penicillin allergy de-labeling into a new arm of antimicrobial stewardship programs (ASPs) has become an increasing global focus. We performed an evidence-based narrative review of the literature of penicillin allergy label carriage, the adverse effects of penicillin allergy labels and current approaches and barriers to penicillin allergy de-labeling. Over the period 1928-2018 in Pubmed and Medline, search terms used included "penicillin allergy" or "penicillin hypersensitivity" alone or in combination with "adverse events", "testing", "evaluation", "effects", "label", "de-labeling", "prick or epicutaneous" and "intradermal" skin testing, "oral challenge or provocation" "cross-reactivity" and "antimicrobial stewardship." This article is protected by copyright. All rights reserved.
DOI: 10.1111/all.13848
ORCID: 0000-0002-5111-6367
Journal: Allergy
PubMed URL: 31049971
Type: Journal Article
Subjects: allergy
Appears in Collections:Journal articles

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