New guideline aids nonallergists in penicillin allergy de-labeling, improving patient care. Read full guideline for implementation insights.
In a clinical practice guideline issued by the British Society for Allergy and Clinical Immunology (BSACI) and published online Sept. 21 in Clinical & Experimental Allergy, recommendations are presented for clinicians not trained in allergy or immunology who wish to develop a penicillin allergy de-labeling service in a hospital setting. The clinical practice guideline is intended to supplement the Standards of Care Committee of the BSACI 2015 guideline.
Louise Savic, M.B.B.S., from Leeds Teaching Hospitals NHS Trust in the United Kingdom, and colleagues note that the recommendations include a checklist to identify patients at low risk for allergy and a framework for the conduct of drug provocation testing (DPT) by nonallergists. Direct DPT should be offered for all patients identified as low risk for true penicillin allergy, providing no exclusion criteria are met (evidence grade, C); DPT requires a set of minimum safety standards (evidence grade, E). For low-risk patients, DPT should be performed by nonallergists in a setting where allergic reactions (including anaphylaxis) can be treated (evidence grade, C).
“The aim of this guideline is to provide a framework for the set-up and delivery of penicillin allergy de-labelling services by nonallergists,” the authors write. “The intended users are nonallergists with an interest in clarifying the penicillin allergy status of their patients. The target population is adult and children with an untested label of penicillin allergy.”
Several authors disclosed financial ties to the pharmaceutical industry.
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