A new pathway for penicillin delabeling in Norway.

Autor:	Alnæs MB; Section of Clinical Allergy, Department of Occupational Medicine, Haukeland University Hospital, 5020 Bergen, Norway.; Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway., Oppegaard O; Department of Medicine, Haukeland University Hospital, 5020 Bergen, Norway.; Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway., Kittang BR; Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway.; Haraldsplass Deaconess Hospital 5009 Bergen, Norway.; Department of Nursing Home Medicine, 5145 Fyllingsdalen, Norway., Lygre SHL; Section of Clinical Allergy, Department of Occupational Medicine, Haukeland University Hospital, 5020 Bergen, Norway., Langeland AB; Department of Medicine, Haukeland University Hospital, 5020 Bergen, Norway., Skodvin B; The Norwegian Advisory Unit for Antibiotic Use in Hospitals, 5020 Bergen, Norway., Bjånes T; Department of Medical Biochemistry and Pharmacology (MBF) Haukeland University Hospital, 5020 Bergen, Norway., Storaas T; Section of Clinical Allergy, Department of Occupational Medicine, Haukeland University Hospital, 5020 Bergen, Norway.
Jazyk:	angličtina
Zdroj:	The World Allergy Organization journal [World Allergy Organ J] 2023 Oct 16; Vol. 16 (11), pp. 100829. Date of Electronic Publication: 2023 Oct 16 (Print Publication: 2023).
DOI:	10.1016/j.waojou.2023.100829
Abstrakt:	Background: 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. Objective: To create and validate the first penicillin delabeling pathway applicable outside an allergy clinic in Norway. Methods: 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. Results: One-hundred forty-nine 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 1 mild reaction. Sixty high-risk patients were eligible for an oral penicillin challenge after allergologic evaluation; 3 patients reacted non-severely. Conclusion: We have created and demonstrated feasibility of the first penicillin delabeling program (PAD) applicable in a hospital setting outside an allergy clinic in Norway. Our data suggest 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. (© 2023 The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu