Please use this identifier to cite or link to this item:
Title: Predictive factors of amoxicillin immediate hypersensitivity and validation of PEN-FAST clinical decision rule.
Austin Authors: Piotin, Anays;Godet, Julien;Trubiano, Jason ;Grandbastien, Manon;Guénard-Bilbault, Lydie;de Blay, Frédéric;Metz-Favre, Carine
Affiliation: Medicine (University of Melbourne)
Infectious Diseases
National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Parkville, Australia
Chest Diseases Department, Strasbourg University Hospital, Strasbourg, France
Public Health Department, Strasbourg University Hospital, Strasbourg, France
Chest Diseases Department, Strasbourg University Hospital, Strasbourg, France
Chest Diseases Department, Strasbourg University Hospital, Strasbourg, France; EA 3070 Federation of Translational Medicine, FHU Homicare, University of Strasbourg, Strasbourg, France
Chest Diseases Department, Strasbourg University Hospital, Strasbourg, France
Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia
Issue Date: Jan-2022
Date: 2021-07-13
Publication information: Annals of Allergy, Asthma & Immunology 2022; 128(1): 27-32
Abstract: The challenge of delabeling amoxicillin allergy is an important issue for patients and clinicians, especially when anaphylaxis is reported. A recent study has proposed a clinical decision rule, PEN-FAST, to identify low-risk penicillin allergies. To validate the PEN-FAST clinical decision rule in a population with high risk of suspected immediate amoxicillin allergy and to identify clinical predictive factors of amoxicillin immediate hypersensitivity. We retrospectively analyzed medical records of patients with a suspected immediate amoxicillin allergy who carried out an allergologic evaluation by a specialist in the Allergy Unit of Strasbourg University Hospital from 2015 to 2020. A total of 142 adult patients (88 women [62.0%]; median age, 52 [interquartile range, 40.3-62.0] years) were analyzed. Most of them reported anaphylaxis (68.8%). Internal validation of PEN-FAST score revealed a good discrimination with area under the curve of 0.86 (95% confidence interval, 0.79-0.92). A cutoff of less than 3 points for PEN-FAST was used to classify 29 from 142 patients at low risk of allergy, of whom only 2 (6.9%) received positive results of allergy testing. The negative predictive value for successful delabeling was 0.93 (95% confidence interval, 0.77-0.99). Predictive clinical features for immediate amoxicillin hypersensitivity were time since reaction (P < .001), time elapsed between drug intake and first symptom (P < .001), severity grade reaction (P < .001), and treatment or hospitalization required (P < .001). PEN-FAST has been validated to identify low-risk penicillin allergies in our European cohort of patients mainly reporting anaphylaxis. This is the first reported external validation of a penicillin allergy clinical decision rule internationally.
DOI: 10.1016/j.anai.2021.07.005
ORCID: 0000-0002-5111-6367
Journal: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
PubMed URL: 34271183
PubMed URL:
Type: Journal Article
Appears in Collections:Journal articles

Show full item record

Page view(s)

checked on Apr 22, 2024

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.