The Who, What, When and Where of Inpatient Direct Oral Penicillin Challenge - Implications for health services implementation

J A Trubiano; S Vogrin; E Mitri; R Hall; A Copaescu; J Waldron; J De Luca; M Rose; G Mackay; B Lambros; A P Douglas; N E Holmes; K 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 Mar 17;ciad156. doi: 10.1093/cid/ciad156. Online ahead of print.

Authors

J A Trubiano^{1

2}, S Vogrin^{1

2}, E Mitri^{1

3}, R Hall¹, A Copaescu^{1

2

4}, J Waldron¹, J De Luca¹, M Rose^{1

2

5}, G Mackay⁶, B Lambros⁵, A P Douglas^{1

5

7}, N E Holmes^{1

2

8}, K Y L Chua¹

Affiliations

¹ Centre for Antibiotic Allergy and Research, Department of Infectious Diseases, Austin Health, Heidelberg VIC 3084.
² Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, 3000, Australia.
³ Department of Pharmacy, Austin Health, VIC 3084.
⁴ Department of Medicine, Division of Allergy and Clinical Immunology, McGill University Health Center, Montreal, QC, 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, NSW 2640.
⁷ Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, 3084.
⁸ Data Analytics Research and Evaluation (DARE) Centre, Austin Health and The University of Melbourne, VIC 3084.

PMID: 36929823
DOI: 10.1093/cid/ciad156

Abstract

Inpatient direct oral challenge programs are increasingly deployed as part of antimicrobial stewardship (AMS) initiatives to reduce the burden and impacts of penicillin allergy labels on antibiotic prescribing. Using data from a prospective multicentre 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.