Differences in beta-lactam and penicillin allergy: Beyond the West and focusing on Asia-Pacific

Article Medicine, General & Internal

Penicillin Allergy Delabeling Program: an exploratory economic evaluation in the Australian context

Natasha K. Brusco et al.

Summary: This study examines the economic advantages of low-risk penicillin delabelling in the Australian context. The findings support the international literature and highlight the economic benefits of delabelling in the inpatient setting.

INTERNAL MEDICINE JOURNAL (2023)

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Article Allergy

Comparative Effectiveness, Safety, and Real-World Outcomes of a Nurse-Led, Protocol-Driven Penicillin Allergy Evaluation From the Hong Kong Drug Allergy Delabelling Initiative (HK-DADI)

Andy K. C. Kan et al.

Summary: The Hong Kong Drug Allergy Delabelling Initiative (HK-DADI), a nurse-led, protocol-driven evaluation, proved to be safe and effective in delabeling penicillin allergy. It also reduced the need for unnecessary skin testing among low-risk patients.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2023)

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Letter Allergy

Direct oral penicillin challenge for penicillin allergy delabeling as a health services intervention: A multicenter cohort study

Jason A. Trubiano et al.

ALLERGY (2022)

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Article Allergy

Safe De-Labeling of Patients at Low Risk of Penicillin Allergy in Denmark

Sara Fransson et al.

Summary: This study investigated the rate of severe allergic reactions to direct oral drug provocation in penicillin allergy patients stratified to be at low risk, as well as barriers to penicillin allergy de-labeling and future use of penicillins. The results showed that direct oral provocation without preceding tests was safe in low-risk patients, with no cases of anaphylaxis or severe delayed hypersensitivity. However, benign delayed skin reactions still occurred.

INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY (2022)

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Article Clinical Neurology

Penicillin Allergy in Spine Surgery: Increased Rates of Sepsis, Emergency Room Visits, and Readmission

Jon Raso et al.

Summary: This study found that a reported penicillin allergy is associated with an increase in sepsis, urinary tract infection, emergency room visit, and readmission within 90 days after PLF and ACDF. The findings can help physicians provide patients with more comprehensive preoperative counseling in the setting of patient-reported penicillin allergy.

WORLD NEUROSURGERY (2022)

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Review Allergy

Patient and Clinician Attitudes Toward Telemedicine for Allergy and Immunology

Allison Ramsey et al.

Summary: The use of telemedicine in allergy/immunology has increased, especially during the COVID-19 pandemic. Patients generally have a positive attitude towards telemedicine, but prefer in-person visits for certain types of encounters. Telemedicine in asthma has provided a model for other allergic and immunologic conditions. Clinician satisfaction is important for the long-term implementation of telemedicine, and factors such as technology quality, reimbursement, and patient/clinician relationships influence this. Future research should focus on gathering more outcome data for other disease states to facilitate better telemedicine policies.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2022)

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Letter Allergy

Retrospective stratification of cephalosporin allergy label risk using validated penicillin allergy frameworks

Grace Koo et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2022)

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Article Biochemistry & Molecular Biology

Changes in Sensitization Patterns in the Last 25 Years in 619 Patients with Confirmed Diagnoses of Immediate Hypersensitivity Reactions to Beta-Lactams

Maria del Valle Campanon Toro et al.

Summary: Beta-lactam (BL) drugs, the most prescribed antibiotics worldwide, are frequently implicated in hypersensitivity reactions. Changes in prescription patterns may influence sensitization patterns to BL drugs.

BIOMEDICINES (2022)

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Article Allergy

Risk-stratified management to remove low-risk penicillin allergy labels in the patients with COVID-19 in the intensive care unit

Joanna L. Stollings et al.

Journal of Allergy and Clinical Immunology-In Practice (2022)

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Article Allergy

Negative impact of penicillin allergy labels on antibiotic use in hospitalized patients in Chinese Mainland

Zihan Jiang et al.

Summary: This retrospective study in Chinese hospitalized patients found a prevalence of 4.00% for penicillin allergy labels. Patients with penicillin allergy labels had significantly different antibiotic prescription patterns compared to control group, resulting in potentially irrational antibiotic prescribing, prolonged hospital stays, and greater need for consultation with infection specialists.

WORLD ALLERGY ORGANIZATION JOURNAL (2022)

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Article Allergy

Hong Kong Drug Allergy Delabelling Initiative (HK-DADI) consensus statements for penicillin allergy testing by nonallergists

Philip H. Li et al.

Summary: Penicillin allergy testing can be conducted by nonallergists in Hong Kong with support from an allergist-led Hub. Consensus statements offer recommendations and guidance for nonallergists to screen for low-risk patients and perform penicillin allergy testing. The CSs cover risk assessment, skin testing, drug provocation testing (DPT), and post-testing management, with a focus on accurate diagnosis and proper patient counseling.

FRONTIERS IN ALLERGY (2022)

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Article Allergy

Prevalence and impact of misdiagnosed drug allergy labels among patients with hereditary angioedema

Jane Chi Yan Wong et al.

Summary: This study found that misdiagnosed and mislabeled drug allergy (DA) labels are prevalent among hereditary angioedema (HAE) patients. Misdiagnosed DA labels are associated with delayed HAE diagnosis and adverse clinical outcomes. Immunologists/allergists should consider proactively reviewing and investigating suspicious DA labels, especially among HAE patients.

FRONTIERS IN ALLERGY (2022)

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Article Immunology

The Penicillin Allergy Delabeling Program: A Multicenter Whole-of-Hospital Health Services Intervention and Comparative Effectiveness Study

Kyra Y. L. Chua et al.

Summary: This study showed that the program of inpatient delabeling for low-risk penicillin allergies using a combination of direct delabeling and oral penicillin challenge led to increased usage of narrow-spectrum penicillins, improved appropriate antibiotic prescribing, and reduced usage of restricted antibiotics.

CLINICAL INFECTIOUS DISEASES (2021)

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Article Orthopedics

Preoperative Allergy Testing for Patients Reporting Penicillin and Cephalosporin Allergies is Cost-Effective in Preventing Infection after Total Knee and Hip Arthroplasty

Nicholas R. Pagani et al.

Summary: Routine preoperative allergy testing for patients reporting penicillin and cephalosporin allergies before total joint arthroplasty is cost-effective for infection prevention. As long as there is a significant reduction in infection rate, this practice remains cost-effective.

JOURNAL OF ARTHROPLASTY (2021)

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Article Dermatology

Telemedicine and Community Health Projects in Asia

Anil Kumar Jha et al.

DERMATOLOGIC CLINICS (2021)

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Article Infectious Diseases

Antimicrobial stewardship capacity and manpower needs in the Asia Pacific

Tau Hong Lee et al.

Summary: Antimicrobial stewardship is a key strategy to combat antimicrobial resistance in hospitals, especially in the Asia Pacific region. A survey of healthcare providers in the field of infectious diseases and microbiology revealed varying levels of antimicrobial control practices, highlighting the need for national guidelines to advance antimicrobial stewardship in this diverse region.

JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE (2021)

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Article Allergy

Penicillin Allergy Assessment in Pregnancy: Safety and Impact on Antibiotic Use

Anna R. Wolfson et al.

Summary: This study found that penicillin allergy testing was safe and associated with significantly reduced broad-spectrum antibiotic use and increased first-line beta-lactam antibiotic use in 220 pregnant patients with penicillin allergy histories who underwent in-person allergy/immunology evaluation.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2021)

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Article Orthopedics

Economic Burden of Patient-Reported Penicillin Allergy on Total Hip and Total Knee Arthroplasty

Olivia C. Lee et al.

Summary: This study evaluates the economic burden of self-reported penicillin allergies in total joint arthroplasty, finding that implementing preoperative penicillin allergy testing could lead to significant cost savings in PJI, saving payors billions of dollars over a span of 20 years.

JOURNAL OF ARTHROPLASTY (2021)

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Article

Implementation of a Pharmacist-Driven Penicillin and Cephalosporin Allergy Assessment Tool: A Pilot Evaluation

Nicole J. Louden et al.

Journal of Pediatric Pharmacology and Therapeutics (2021)

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Review Allergy

Drug allergy management in the elderly

Jane C. Y. Wong et al.

Summary: Management of drug allergies in the elderly has been under-emphasized previously, but recent studies have shed light on the epidemiology and prevalence trends, particularly focusing on anaphylaxis. Understanding these findings can help identify barriers in drug allergy management and develop strategies to overcome them. A proposed approach to drug allergy management based on previous studies and local experience can be beneficial in improving care for older adults.

CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY (2021)

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Review Biochemistry & Molecular Biology

Genotyping HLA alleles to predict the development of Severe cutaneous adverse drug reactions (SCARs): state-of-the-art

Thawinee Jantararoungtong et al.

Summary: Pharmacogenomics has potential in reducing severe cutaneous adverse drug reactions (SCARs) by revealing associations between HLA genes and SCARs. Guidelines from regulatory agencies and professional organizations are available for the translation of SCARs pharmacogenomics research into clinical practice. However, adopting HLA screening on a wider scale in clinical practice requires significant resources and evidence of cost-effectiveness.

EXPERT OPINION ON DRUG METABOLISM & TOXICOLOGY (2021)

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Article Allergy

Penicillin Allergy Label Increases Risk of Worse Clinical Outcomes in COVID-19

Lauren W. Kaminsky et al.

Summary: The study found that COVID-19 patients with a PCN allergy label had higher risks for hospitalization, acute respiratory failure, intensive care unit requirement, and mechanical ventilation, but no significant difference in mortality rate. Even after excluding patients with bacterial infections, similar results were obtained.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2021)

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Review Allergy

Prevention of Drug Hypersensitivity Reactions: Prescreening and Premedication

Bernard Yu-Hor Thong et al.

Summary: Drug hypersensitivity reactions are complex in nature and can be managed through a combination of pre-screening, pre-medication, and genetic testing. These strategies can help identify causative drugs, prevent adverse reactions, and guide treatment plans in different clinical scenarios.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2021)

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Article Allergy

Risk factors of beta-lactam anaphylaxis in Korea: A 6-year multicenter retrospective adult case-control study

Chan Sun Park et al.

Summary: The study revealed that cephalosporins are the main cause of anaphylaxis, with ceftriaxone, cefazedone, and cefbuperazone being the most common derivatives. Risk factors include a history of drug allergies, previous exposure to the causative BL, and the concurrent use of ACE inhibitors.

WORLD ALLERGY ORGANIZATION JOURNAL (2021)

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Article Medicine, General & Internal

Epidemiology and outcomes of geriatric and non-geriatric patients with drug allergy labels in Hong Kong

Philip H. Li et al.

Summary: More than 13% of hospitalised geriatric patients had drug allergy labels, with cardiovascular system drugs being a common allergen. Geriatric patients had a significantly lower rate of direct discharge from the hospital and required more transfers for further care, highlighting the importance of managing drug allergies in this population.

HONG KONG MEDICAL JOURNAL (2021)

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Article Allergy

Piperacillin-Tazobactam Allergies: An Exception to Usual Penicillin Allergy

Jane C. Y. Wong et al.

Summary: This study investigated the epidemiology, clinical characteristics, testing outcomes, and predictive value of skin tests in patients referred for suspected PT allergies in Hong Kong public hospitals from 2015 to 2019. The results showed an increase in both PT prescriptions and newly reported PT allergies during this period. The majority of suspected PT allergies had underlying medical conditions or immunosuppressant use, with a diagnosis rate of PT allergy at 32.4% and a poor NPV of skin tests. The study suggests that drug provocation testing remains the gold standard for accurate diagnosis in suspected PT allergies.

ALLERGY ASTHMA & IMMUNOLOGY RESEARCH (2021)

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Article Allergy

Multicenter Australian Study to Determine Criteria for Low- and High-Risk Penicillin Testing in Outpatients

Brittany Stevenson et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2020)

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Article Allergy

Adverse Reactions Associated with Penicillins, Carbapenems, Monobactams, and Clindamycin: A Retrospective Population-based Study

Emily H. Liang et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2020)

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Editorial Material Health Policy & Services

Possibility of introducing telemedicine services in Asian and African countries

Teppei Suzuki et al.

HEALTH POLICY AND TECHNOLOGY (2020)

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Article Medicine, General & Internal

Development and Validation of a Penicillin Allergy Clinical Decision Rule

Jason A. Trubiano et al.

JAMA INTERNAL MEDICINE (2020)

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Letter Allergy

Patient satisfaction with telemedicine encounters in an allergy and immunology practice during the coronavirus disease 2019 pandemic

S. Shahzad Mustafa et al.

ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY (2020)

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Article Allergy

Health-Related Quality of Life in Common Variable Immunodeficiency Italian Patients Switched to Remote Assistance the COVID-19 Pandemic

Federica Pulvirenti et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2020)

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Article Medicine, General & Internal

Prevalence, Incidence, and Sensitization Profile of β-lactam Antibiotic Allergy in Hong Kong

Philip H. Li et al.

JAMA NETWORK OPEN (2020)

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Article Medicine, General & Internal

Prevalence and Impact of Reported Drug Allergies among Rheumatology Patients

Shirley Chiu Wai Chan et al.

DIAGNOSTICS (2020)

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Article Allergy

Diagnostic procedures & practices in drug allergy/hypersensitivity: a survey of 13 Asian countries

Min-Moon Tang et al.

ASIA PACIFIC ALLERGY (2020)

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Review Allergy

Drug hypersensitivity reactions in Asia: regional issues and challenges

Bernard Yu-Hor Thong et al.

ASIA PACIFIC ALLERGY (2020)

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Article Pediatrics

Time Has Come for Routine Penicillin Allergy Testing in Obstetrics

Elizabeth Cook et al.

AJP REPORTS (2020)

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Article Allergy

A Retrospective Critical Analysis and Risk Stratification of Penicillin Allergy Delabeling in a UK Specialist Regional Allergy Service

Omar E. Mohamed et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2019)

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Article Infectious Diseases

Implementation of a pharmacist-led penicillin allergy de-labelling service in a public hospital

Tanya du Plessis et al.

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY (2019)

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Article Infectious Diseases

Evaluation of a pharmacist-led penicillin allergy de-labelling ward round: a novel antimicrobial stewardship intervention

M. Devchand et al.

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY (2019)

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Article Allergy

Identifying Low-Risk Beta-Lactam Allergy Patients in a UK Tertiary Centre

Leonard Quok Chean et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2019)

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Article Allergy

Beta-lactam allergy in Chinese patients and factors predicting genuine allergy

Philip Hei Li et al.

WORLD ALLERGY ORGANIZATION JOURNAL (2019)

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Review Allergy

Controversies in Drug Allergy: Beta-Lactam Hypersensitivity Testing

Maria J. Torres et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2019)

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Review Allergy

The unmet provision of allergy services in Hong Kong impairs capability for allergy prevention - implications for the Asia Pacific region

Tak-hong Lee et al.

ASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY (2019)

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Article Infectious Diseases

Trends and patterns of national antimicrobial consumption in Japan from 2004 to 2016

Atsuko Tsutsui et al.

JOURNAL OF INFECTION AND CHEMOTHERAPY (2018)

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Review Allergy

The Cost of Self-Reported Penicillin Allergy: A Systematic Review

T. Joseph Mattingly et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2018)

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Article Allergy

The Use of Telemedicine for Penicillin Allergy Skin Testing

Mary L. Staicu et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2018)

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Editorial Material Medicine, General & Internal

Penicillin Allergy Is Not Necessarily Forever

Jason A. Trubiano et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2017)

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Letter Allergy

HLA B62 as a possible risk factor for drug reaction with eosinophilia and systemic symptoms to piperacillin/tazobactam

Krzysztof Rutkowski et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2017)

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Article Allergy

The Effect of Penicillin Allergy Testing on Future Health Care Utilization: A Matched Cohort Study

Eric Macy et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2017)

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Review Allergy

Clinical outcomes following inpatient penicillin allergy testing: A systematic review and meta-analysis

K. A. Sacco et al.

ALLERGY (2017)

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Article Computer Science, Information Systems

Identifying opportunities in EHR to improve the quality of antibiotic allergy data

Jaclynn M. Moskow et al.

JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION (2016)

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Article Allergy

Drug allergies documented in electronic health records of a large healthcare system

L. Zhou et al.

ALLERGY (2016)

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Article Medicine, General & Internal

The revolving door: antibiotic allergy labelling in a tertiary care centre

B. Knezevic et al.

INTERNAL MEDICINE JOURNAL (2016)

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Article Infectious Diseases

Antimicrobial allergy 'labels' drive inappropriate antimicrobial prescribing: lessons for stewardship

J. A. Trubiano et al.

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY (2016)

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Article Allergy

The High Impact of Penicillin Allergy Registration in Hospitalized Patients

Savannah M. van Dijk et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2016)

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Article Allergy

Adverse reactions associated with oral and parenteral use of cephalosporins: A retrospective population-based analysis

Eric Macy et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY (2015)

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Article Allergy

Improving the Effectiveness of Penicillin Allergy De-labeling

Jack Bourke et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2015)

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Article Allergy

International Consensus on drug allergy

P. Demoly et al.

ALLERGY (2014)

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Article Allergy

Prevalence and characteristics of reported penicillin allergy in an urban outpatient adult population

Stephanie Albin et al.

ALLERGY AND ASTHMA PROCEEDINGS (2014)

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Review Allergy

Penicillin and Beta-Lactam Allergy: Epidemiology and Diagnosis

Eric Macy

CURRENT ALLERGY AND ASTHMA REPORTS (2014)

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Article Allergy

Treatment of Patients with a History of Penicillin Allergy in a Large Tertiary-Care Academic Hospital

Matthieu Picard et al.

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE (2013)

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Article Infectious Diseases

European Surveillance of Antimicrobial Consumption (ESAC): outpatient penicillin use in Europe (1997-2009)

Ann Versporten et al.

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY (2011)

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Article Immunology

Update on the evaluation of hypersensitivity reactions to betalactams

M. Blanca et al.

ALLERGY (2009)

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Article Emergency Medicine

The Use of Penicillin Skin Testing to Assess the Prevalence of Penicillin Allergy in an Emergency Department Setting

Ali S. Raja et al.

ANNALS OF EMERGENCY MEDICINE (2009)

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Article Biology

Emerging antibiotic resistance in bacteria with special reference to India

D. Raghunath

JOURNAL OF BIOSCIENCES (2008)

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Differences in beta-lactam and penicillin allergy: Beyond the West and focusing on Asia-Pacific

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