TOPLINE:
A pediatric emergency department (PED) study has shown the efficacy of penicillin allergy delabeling, which can reduce adverse health outcomes in children with parent-reported penicillin allergies.
METHODOLOGY:
Approximately 10% of children presenting to PEDs have reported parent-reported allergies to a penicillin family antibiotic, which leads to adverse health outcomes and increased healthcare costs.
Delabeling a penicillin allergy through a Direct oral challenge (DOC) in low-risk children can improve health outcomes.
This cohort study included children aged 2-16 years presenting to one of the three sites between March 2019 and November 2020, with their parents completing penicillin allergy symptom questionnaires.
117 participants with low-risk symptoms completed DOC.
TAKEAWAY:
Physicians delabeled 98% of reported penicillin allergy in low-risk children.
Significant differences were noted among the three sites (A, B, and C) for:
low-risk designation level (57%, 69%, and 46%, respectively; P < .001);
family interest in receiving DOC (87%, 75%, and 58%; P < .02); and
clinician willingness to proceed with DOC (85%, 94%, and 56%; P < .001).
Physicians decided not to perform DOC 19 times, with time constraints being the most frequent reason.
IN PRACTICE:
"DOC could be most beneficial for children requiring immediate antibiotic treatment. Integration of DOC into a standardized electronic medical record system is the next step to address the issue of overly reported penicillin allergies, which could help to prevent unnecessary allergy labels and simplify the process for allergy testing referrals," the researchers concluded.
SOURCE:
The study was conducted by Vyles D, DO, MS, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, and colleagues and was published in JAMA Pediatrics on October 02, 2023.
LIMITATIONS:
The penicillin allergy symptom questionnaires administered to children and their parents differed between sites.
DISCLOSURES:
Phillips EJ received personal fees from Verve, Janssen, UpToDate, AstraZeneca, and Biocryst, as well as grants from the National Institutes of Health and National Health and Medical Research Council. No other disclosures were reported.
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Cite this: Successful Penicillin Allergy Delabeling in Pediatric ED - Medscape - Oct 19, 2023.
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