Details

Autor(en) / Beteiligte

• Alnæs, Marie Bjørbak
• Oppegaard, Oddvar
• Kittang, Bård Reiakvam
• Lygre, Stein Håkon Låstad
• Langeland, Anine Bernhoft
• Skodvin, Brita
• Bjånes, Tormod
• Storaas, Torgeir

Titel

A new pathway for penicillin delabeling in Norway

Ist Teil von

• The World Allergy Organization journal, 2023-11, Vol.16 (11), p.100829-100829, Article 100829

Ort / Verlag

Elsevier Inc

Erscheinungsjahr

2023

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Penicillin allergy is self-reported by 3–10% of patients admitted to hospital. The label is wrong in 90% of the cases and has severe health implications. Penicillin-delabeling can reverse the negative effects of the label, and pathways adapted to local practice are needed. No tools are available in Norway for penicillin delabeling outside an allergy clinic. To create and validate the first penicillin delabeling pathway applicable outside an allergy clinic in Norway. An interdisciplinary taskforce created a penicillin allergy delabeling program (PAD) adapted to the Norwegian health care system. This was validated in a prospective, single-center study. Very low-risk and low-risk patients underwent a direct oral penicillin challenge and high-risk patients were referred for allergologic evaluation. 149 patients declaring penicillin allergy were included. Seventy-four (50%) were very-low- and low risk patients suitable for a direct oral penicillin challenge resulting in only one mild reaction. 60 high-risk patients were eligible for an oral penicillin challenge after allergologic evaluation, three patients reacted non-severely. We have created and demonstrated feasibility of the first PAD applicable in a hospital setting outside an allergy clinic in Norway. Our data suggests this is safe and beneficial, with 49% patients delabeled through a direct oral penicillin challenge, performed without any serious adverse events, and an overall 87% delabeling rate. •What is already known about this topic? Penicillin delabeling pathways have been implemented in several countries and show to be feasible and safe. There are several publications from Australia and USA on penicillin delabeling, but much less from Northern Europe paradoxically enough since in particular Scandinavian countries still have penicillin as a first treatment option in most clinical settings. In Norway no validated tools or pathways for penicillin delabeling are available.•What does this article add to our knowledge? We developed and validated the first penicillin allergy program applicable outside an allergology clinic in Norway. The validation process ensures a pathway applicable and feasible for the health system it is meant to be used. This facilitates non allergologists and nurses to safely and empowered delabel patients outside an allergology clinic. Almost 50% of the patients could be delabeled directly through an untitrated oral penicillin challenge. The program is safe, feasible and applicable.•How does this study impact current management guidelines? The study has facilitated a change of practice for the handling of patients declaring penicillin allergy referred to our hospital. The pathway is to be implemented in further hospitals and implemented as a part of the Norwegian guidelines for the use of antibiotics in a hospital setting.