Adult penicillin allergy programmes in Australian hospitals: a practical guide from the National Antibiotic Allergy Network

Rory Hannah¹, Elise Mitri^{2

3}, Constance H Katelaris⁴, Jennifer O'Hern⁵, Minyon Avent^{6

7}, Glenn Valoppi⁸, Matthew Rawlins⁹, Catherine Frith^{10

11}, Brendan McMullan^{12

13}, David Kong^{14

15}, Kyra Chua^{2

3}, Amy Legg^{16

17}, Rod James^{14

18

19}, Sonja Janson²⁰, Carolyn Hawkins^{21

22}, Katrina Randall^{21

22}, Courtney Ierano^{14

19}, Karin Thursky^{14

19

23

24}, Jason A Trubiano^{2

3}

Affiliations

¹ Department of Infectious Diseases, Clinical Immunology and Allergy, Division of Medicine, Lyell McEwin Hospital, Adelaide, South Australia, Australia.
² Centre for Antibiotic Allergy and Research, Department of Infectious Diseases and Immunology, Austin Health, Melbourne, Victoria, Australia.
³ Department of Infectious Diseases, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Immunology/Allergy Unit, Department of Medicine, Campbelltown Hospital and Western Sydney University, Sydney, New South Wales, Australia.
⁵ Department of Infectious Diseases, Launceston General Hospital, Launceston, Tasmania, Australia.
⁶ Queensland Statewide Antimicrobial Stewardship Program, Queensland Health, Brisbane, Queensland, Australia.
⁷ Faculty of Medicine, University of Queensland Centre for Clinical Research (UQCCR), University of Queensland, Brisbane, Queensland, Australia.
⁸ Slade Pharmacy, Epworth Healthcare, Melbourne, Victoria, Australia.
⁹ Department of Pharmacy, Fiona Stanley Hospital, Perth, Western Australia, Australia.
¹⁰ Department of Immunology, Sydney Children's Hospital, Sydney, New South Wales, Australia.
¹¹ School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
¹² Department of Infectious Diseases, Sydney Children's Hospital, Sydney, New South Wales, Australia.
¹³ School of Clinical Medicine, Discipline of Paediatrics, University of New South Wales, Sydney, New South Wales, Australia.
¹⁴ Department of Infectious Diseases, National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
¹⁵ Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
¹⁶ Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
¹⁷ Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
¹⁸ Microbiological Diagnostic Unit - Public Health Laboratory, Peter Doherty Institute for Infection and Immunology, Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia.
¹⁹ Royal Melbourne Hospital Guidance Group, Melbourne Health, Melbourne, Victoria, Australia.
²⁰ Department of Infectious Diseases, Royal Darwin Hospital and Northern Territory Medical Program, Darwin, Northern Territory, Australia.
²¹ Department of Immunology, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
²² School of Medicine and Psychology, Australian National University, Canberra, Australian Capital Territory, Australia.
²³ National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
²⁴ Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.

PMID: 39444148
DOI: 10.1111/imj.16543

Practice Guideline

Adult penicillin allergy programmes in Australian hospitals: a practical guide from the National Antibiotic Allergy Network

Rory Hannah et al. Intern Med J. 2024 Nov.

. 2024 Nov;54(11):1883-1893.

doi: 10.1111/imj.16543. Epub 2024 Oct 23.

Authors

Affiliations

¹ Department of Infectious Diseases, Clinical Immunology and Allergy, Division of Medicine, Lyell McEwin Hospital, Adelaide, South Australia, Australia.
² Centre for Antibiotic Allergy and Research, Department of Infectious Diseases and Immunology, Austin Health, Melbourne, Victoria, Australia.
³ Department of Infectious Diseases, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Immunology/Allergy Unit, Department of Medicine, Campbelltown Hospital and Western Sydney University, Sydney, New South Wales, Australia.
⁵ Department of Infectious Diseases, Launceston General Hospital, Launceston, Tasmania, Australia.
⁶ Queensland Statewide Antimicrobial Stewardship Program, Queensland Health, Brisbane, Queensland, Australia.
⁷ Faculty of Medicine, University of Queensland Centre for Clinical Research (UQCCR), University of Queensland, Brisbane, Queensland, Australia.
⁸ Slade Pharmacy, Epworth Healthcare, Melbourne, Victoria, Australia.
⁹ Department of Pharmacy, Fiona Stanley Hospital, Perth, Western Australia, Australia.
¹⁰ Department of Immunology, Sydney Children's Hospital, Sydney, New South Wales, Australia.
¹¹ School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
¹² Department of Infectious Diseases, Sydney Children's Hospital, Sydney, New South Wales, Australia.
¹³ School of Clinical Medicine, Discipline of Paediatrics, University of New South Wales, Sydney, New South Wales, Australia.
¹⁴ Department of Infectious Diseases, National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
¹⁵ Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
¹⁶ Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
¹⁷ Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
¹⁸ Microbiological Diagnostic Unit - Public Health Laboratory, Peter Doherty Institute for Infection and Immunology, Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia.
¹⁹ Royal Melbourne Hospital Guidance Group, Melbourne Health, Melbourne, Victoria, Australia.
²⁰ Department of Infectious Diseases, Royal Darwin Hospital and Northern Territory Medical Program, Darwin, Northern Territory, Australia.
²¹ Department of Immunology, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
²² School of Medicine and Psychology, Australian National University, Canberra, Australian Capital Territory, Australia.
²³ National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
²⁴ Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.

PMID: 39444148
DOI: 10.1111/imj.16543

Abstract

Penicillin allergy is a significant burden on patient, prescribing and hospital outcomes. There has been increasing interest in the incorporation of penicillin allergy testing (i.e. delabelling) into antimicrobial stewardship (AMS) programmes to reduce the burden of penicillin allergy labels and improve prescribing. In particular, there has been a focus on point-of-care penicillin allergy assessment and direct oral challenge for low-risk phenotypes. The National Antibiotic Allergy Network has provided a guide to assist AMS clinicians with the incorporation of penicillin allergy programmes, in particular direct oral challenge, into Australian hospitals.

Keywords: antimicrobial allergy; beta‐lactam allergy; delabelling; oral challenge; penicillin allergy.

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References

1. Trubiano JA, Chen C, Cheng AC, Grayson ML, Slavin MA, Thursky KA et al. Antimicrobial allergy ‘labels’ drive inappropriate antimicrobial prescribing: lessons for stewardship. J Antimicrob Chemother 2016; 71: 1715–1722.
1. Knezevic B, Sprigg D, Seet J, Trevenen M, Trubiano J, Smith W et al. The revolving door: antibiotic allergy labelling in a tertiary care centre. Intern Med J 2016; 46: 1276–1283.
1. Lucas M, Arnold A, Sommerfield A, Trevenen M, Braconnier L, Schilling A et al. Antibiotic allergy labels in children are associated with adverse clinical outcomes. J Allergy Clin Immunol Pract 2018; 7: 975–982.
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1. Arnold A, Coventry LL, Foster MJ, Koplin JJ, Lucas M. The burden of self‐reported antibiotic allergies in health care and how to address it: a systematic review of the evidence. J Allergy Clin Immunol Pract 2023; 11: 3133–3145.e3.

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Adult penicillin allergy programmes in Australian hospitals: a practical guide from the National Antibiotic Allergy Network

Affiliations

Adult penicillin allergy programmes in Australian hospitals: a practical guide from the National Antibiotic Allergy Network

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical