The Who, What, When, and Where of Inpatient Direct Oral Penicillin Challenge-Implications for Health Services Implementation

Jason Anthony Trubiano; Sara Vogrin; Elise Mitri; Rebecca Hall; Ana Copaescu; Jamie Waldron; Joseph De Luca; Morgan Rose; Geoff Mackay; Belinda Lambros; Abby P Douglas; Natasha E Holmes; Kyra Y L Chua

doi:10.1093/cid/ciad156

The Who, What, When, and Where of Inpatient Direct Oral Penicillin Challenge-Implications for Health Services Implementation

Clin Infect Dis. 2023 Jul 5;77(1):19-22. doi: 10.1093/cid/ciad156.

Authors

Jason Anthony Trubiano^{1

2}, Sara Vogrin^{1

2}, Elise Mitri^{1

2

3}, Rebecca Hall¹, Ana Copaescu^{1

2

4}, Jamie Waldron¹, Joseph De Luca¹, Morgan Rose^{1

2

5}, Geoff Mackay⁶, Belinda Lambros⁵, Abby P Douglas^{1

5

7}, Natasha E Holmes^{1

2

8}, Kyra Y L Chua¹

Affiliations

¹ Department of Infectious Diseases, Centre for Antibiotic Allergy and Research, Austin Health, Heidelberg, Victoria, Australia.
² Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
³ Department of Pharmacy, Austin Health, Heidelberg, Victoria, Australia.
⁴ Department of Medicine, Division of Allergy and Clinical Immunology, McGill University Health Center, Montreal, Quebec, Canada.
⁵ Department of Infectious Diseases, The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.
⁶ Albury Wodonga Health, Albury, New South Wales, Australia.
⁷ Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.
⁸ Data Analytics Research and Evaluation (DARE) Centre, Austin Health and The University of Melbourne, Heidelberg, Victoria, Australia.

PMID: 36929823
DOI: 10.1093/cid/ciad156

Abstract

Inpatient direct oral challenge programs are increasingly deployed as part of antimicrobial stewardship initiatives to reduce the burden and impacts of penicillin allergy labels on antibiotic prescribing. Using data from a prospective, multicenter cohort inpatient penicillin allergy program, we identify the key targets for delabeling to aid health service implementation.

Keywords: amoxicillin allergy; antimicrobial stewardship; beta-lactam allergy; drug allergy; oral provocation.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / adverse effects
Drug Hypersensitivity*
Humans
Hypersensitivity*
Inpatients
Penicillins / adverse effects
Prospective Studies

Substances

Penicillins
Anti-Bacterial Agents