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https://ahro.austin.org.au/austinjspui/handle/1/24520
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DC Field | Value | Language |
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dc.contributor.author | Chua, Kyra Y L | - |
dc.contributor.author | Vogrin, Sara | - |
dc.contributor.author | Bury, Susan | - |
dc.contributor.author | Douglas, Abby | - |
dc.contributor.author | Holmes, Natasha E | - |
dc.contributor.author | Tan, Nixon | - |
dc.contributor.author | Brusco, Natasha K | - |
dc.contributor.author | Hall, Rebecca | - |
dc.contributor.author | Lambros, Belinda | - |
dc.contributor.author | Lean, Jacinta | - |
dc.contributor.author | Stevenson, Wendy | - |
dc.contributor.author | Devchand, Misha | - |
dc.contributor.author | Garrett, Kent | - |
dc.contributor.author | Thursky, Karin | - |
dc.contributor.author | Grayson, M Lindsay | - |
dc.contributor.author | Slavin, Monica A | - |
dc.contributor.author | Phillips, Elizabeth J | - |
dc.contributor.author | Trubiano, Jason | - |
dc.date | 2020-08-02 | - |
dc.date.accessioned | 2020-09-28T20:42:02Z | - |
dc.date.available | 2020-09-28T20:42:02Z | - |
dc.date.issued | 2021-08-02 | - |
dc.identifier.citation | Clinical Infectious Diseases 2021; 73(3): 487-496 | en |
dc.identifier.uri | https://ahro.austin.org.au/austinjspui/handle/1/24520 | - |
dc.description.abstract | Penicillin allergies are associated with inferior patient and antimicrobial stewardship outcomes. We implemented a whole-of-hospital program to assess the efficacy of inpatient delabeling for low-risk penicillin allergies in hospitalized inpatients. Patients ≥ 18 years of age with a low-risk penicillin allergy were offered a single-dose oral penicillin challenge or direct label removal based on history (direct delabeling). The primary endpoint was the proportion of patients delabeled. Key secondary endpoints were antibiotic utilization pre- (index admission) and post-delabeling (index admission and 90 days). Between 21 January 2019 and 31 August 2019, we assessed 1791 patients reporting 2315 antibiotic allergies, 1225 with a penicillin allergy. Three hundred fifty-five patients were delabeled: 161 by direct delabeling and 194 via oral penicillin challenge. Ninety-seven percent (194/200) of patients were negative upon oral penicillin challenge. In the delabeled patients, we observed an increase in narrow-spectrum penicillin usage (adjusted odds ratio [OR], 10.51 [95% confidence interval {CI}, 5.39-20.48]), improved appropriate antibiotic prescribing (adjusted OR, 2.13 [95% CI, 1.45-3.13]), and a reduction in restricted antibiotic usage (adjusted OR, 0.38 [95% CI, .27-.54]). In the propensity score analysis, there was an increase in narrow-spectrum penicillins (OR, 10.89 [95% CI, 5.09-23.31]) and β-lactam/β-lactamase inhibitors (OR, 6.68 [95% CI, 3.94-11.35]) and a reduction in restricted antibiotic use (OR, 0.52 [95% CI, .36-.74]) and inappropriate prescriptions (relative risk ratio, 0.43 [95% CI, .26-.72]) in the delabeled group compared with the group who retained their allergy label. This health services program using a combination of direct delabeling and oral penicillin challenge resulted in significant impacts on the use of preferred antibiotics and appropriate prescribing. | en |
dc.language.iso | eng | - |
dc.subject | antibiotic allergy | en |
dc.subject | antimicrobial stewardship | en |
dc.subject | direct provocation | en |
dc.subject | oral challenge | en |
dc.subject | penicillin allergy | en |
dc.title | The Penicillin Allergy Delabeling Program: A Multicenter Whole-of-Hospital Health Services Intervention and Comparative Effectiveness Study. | en |
dc.type | Journal Article | en |
dc.identifier.journaltitle | Clinical Infectious Diseases | en |
dc.identifier.affiliation | Department of Medicine, St Vincent's Hospital, University of Melbourne, Fitzroy, Australia | en |
dc.identifier.affiliation | Pharmacy | en |
dc.identifier.affiliation | Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Australia | en |
dc.identifier.affiliation | Department of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA | en |
dc.identifier.affiliation | Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Australia | en |
dc.identifier.affiliation | Department of Oncology, Sir Peter MacCallum Cancer Centre, University of Melbourne, Parkville, Australia | en |
dc.identifier.affiliation | National Centre for Antimicrobial Stewardship, Royal Melbourne Hospital, Melbourne, Australia | en |
dc.identifier.affiliation | Infectious Diseases | en |
dc.identifier.affiliation | Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Frankston, Australia | en |
dc.identifier.affiliation | Alpha Crucis Group, Health Economics, Langwarrin, Australia | en |
dc.identifier.affiliation | Department of Infectious Diseases and the National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Parkville, Australia | en |
dc.identifier.affiliation | Centre for Antibiotic Allergy and Research | en |
dc.identifier.doi | 10.1093/cid/ciaa653 | en |
dc.type.content | Text | en |
dc.identifier.pubmedid | 32756983 | - |
local.name.researcher | Chua, Kyra Y L | - |
item.languageiso639-1 | en | - |
item.fulltext | No Fulltext | - |
item.grantfulltext | none | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.cerifentitytype | Publications | - |
item.openairetype | Journal Article | - |
crisitem.author.dept | Microbiology | - |
crisitem.author.dept | Infectious Diseases | - |
crisitem.author.dept | Infectious Diseases | - |
crisitem.author.dept | Data Analytics Research and Evaluation (DARE) Centre | - |
crisitem.author.dept | Pharmacy | - |
crisitem.author.dept | Pharmacy | - |
crisitem.author.dept | Infectious Diseases | - |
crisitem.author.dept | Infectious Diseases | - |
crisitem.author.dept | Medicine (University of Melbourne) | - |
crisitem.author.dept | Centre for Antibiotic Allergy and Research | - |
Appears in Collections: | Journal articles |
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