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Title: ESCAPE-Allergy: Evaluating screening for children and adolescents with penicillin allergy.
Austin Authors: Rischin, Kobi J;Mostaghim, Mona;Rao, Arjun;Smith, Bridget;O'Brien, Tracey A;Trubiano, Jason ;Frith, Katie;McMullan, Brendan
Affiliation: Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Sydney, New South Wales, Australia
Pharmacy Department, Sydney Children's Hospital, Sydney, New South Wales, Australia
Emergency Department, Sydney Children's Hospital, Sydney, New South Wales, Australia
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
Infectious Diseases
National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
School of Women's and Children's Heath, University of New South Wales, Sydney, New South Wales, Australia
Issue Date: 2022
Date: 2021
Publication information: Journal of paediatrics and child health 2022-01; 58(1): 83-89
Abstract: Penicillin allergy labels are frequently encountered in children and are associated with significant harms. Most children are falsely labelled and can safely tolerate a penicillin but delabelling strategies are underutilised and paediatric-specific resources are lacking. The aim of this study was to evaluate an allergy assessment tool for children in hospital. We evaluated a paediatric-adapted penicillin allergy assessment tool, using an online survey of clinicians in a tertiary paediatric hospital, with 10 hypothetical potential penicillin allergy or adverse reaction cases (including non-allergy reactions). For each case, respondents were asked to use the tool to assign a reaction phenotype and recommend management. We determined the tool's sensitivity, specificity and acceptability to end users. We evaluated 30 complete survey responses from senior and junior medical staff, nurses and pharmacists. The tool's overall sensitivity was 80.7% (95% confidence interval (CI) 74.2-87.1%) for assigning the correct reaction phenotype and 85.3% (95% CI 79.4-91.3%) for appropriate management. The tool had high sensitivity for identifying immediate hypersensitivity reactions at 95.6% (95% CI 90.2-100%). Most respondents agreed or strongly agreed that they would use the tool in their practice (22/30, 73.3%). This survey evaluated a paediatric-adapted penicillin allergy assessment tool in a tertiary paediatric hospital among multidisciplinary clinician groups. The tool performed well overall and had high safety in identifying immediate hypersensitivity reactions. Further research to support implementation of allergy assessment and delabelling programmes among children is required.
DOI: 10.1111/jpc.15657
ORCID: 0000-0002-3381-3644
Journal: Journal of Paediatrics and Child Health
PubMed URL: 34323321
Type: Journal Article
Subjects: adverse effect
antibacterial agent
antimicrobial stewardship
drug hypersensitivity
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