PMID- 36041964
OWN - NLM
STAT- MEDLINE
DCOM- 20230124
LR  - 20230202
IS  - 1544-3450 (Electronic)
IS  - 1086-5802 (Linking)
VI  - 63
IP  - 1
DP  - 2023 Jan-Feb
TI  - Evaluation of a pharmacist-led penicillin allergy testing service in a community 
      health system.
PG  - 169-172
LID - S1544-3191(22)00273-4 [pii]
LID - 10.1016/j.japh.2022.08.002 [doi]
AB  - BACKGROUND: Roughly 10% of the U.S. population has a documented penicillin (PCN) 
      allergy. Among these individuals, over 95% are able to tolerate PCNs. The 
      inability to use PCNs can result in suboptimal outcomes. In August 2019, Lawrence 
      Memorial Hospital Health System implemented a pharmacist-led PCN allergy testing 
      service to assist with delabeling PCN allergies and increase access to this class 
      of antibiotics. OBJECTIVES: The primary objective was to describe the number of 
      patients who underwent PCN allergy testing and were delabeled from PCN allergy. A 
      secondary objective was to report the number of patients who received and 
      tolerated PCN antibiotics after being delabeled from PCN allergy. METHODS: This 
      retrospective chart review was conducted during the initial 17 months of a 
      pharmacist-led PCN allergy testing service. Eligible patients with a history of 
      an immunoglobulin E (IgE)-mediated reaction underwent a 3-step test that 
      consisted of a scratch test, an intradermal test, and an oral challenge. Eligible 
      patients who did not have a history of IgE-mediated reaction underwent a 2-step 
      graded oral challenge. Descriptive statistics were used for data analysis. 
      RESULTS: Between August 2019 and January 2022, 70 patients underwent testing, and 
      66 patients were delabeled from PCN allergy. Four patients who underwent the 
      3-step test developed reactions of mild to moderate severity. All patients who 
      underwent the graded oral challenge were delabeled from PCN allergy. The rate of 
      PCN allergy was 5.7%, whereas the rate of type I IgE-mediated reaction was 1.4%. 
      All 23 patients who received an antibiotic from the PCN class after a negative 
      allergy test tolerated the PCN antibiotic without an incident. CONCLUSION: PCN 
      allergy testing is an effective way to delabel PCN allergies from most patients 
      presenting with a PCN allergy history. Skin testing followed by an oral challenge 
      or a graded oral challenge alone are safe methods for conducting PCN allergy 
      testing in the primary care setting.
CI  - Copyright (c) 2022 American Pharmacists Association(R). Published by Elsevier Inc. 
      All rights reserved.
FAU - Fanizza, Frank A
AU  - Fanizza FA
FAU - Stump, Hannah
AU  - Stump H
FAU - Carter, Elizabeth
AU  - Carter E
FAU - Prohaska, Emily
AU  - Prohaska E
LA  - eng
PT  - Journal Article
DEP - 20220805
PL  - United States
TA  - J Am Pharm Assoc (2003)
JT  - Journal of the American Pharmacists Association : JAPhA
JID - 101176252
RN  - 0 (Penicillins)
RN  - 0 (Anti-Bacterial Agents)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Humans
MH  - Pharmacists
MH  - Retrospective Studies
MH  - Community Health Planning
MH  - Penicillins/adverse effects
MH  - Anti-Bacterial Agents/adverse effects
MH  - *Drug Hypersensitivity/diagnosis/drug therapy/epidemiology
MH  - Skin Tests/methods
MH  - Immunoglobulin E
MH  - *Hypersensitivity/drug therapy
EDAT- 2022/08/31 06:00
MHDA- 2023/01/25 06:00
CRDT- 2022/08/30 22:14
PHST- 2022/04/29 00:00 [received]
PHST- 2022/08/02 00:00 [revised]
PHST- 2022/08/02 00:00 [accepted]
PHST- 2022/08/31 06:00 [pubmed]
PHST- 2023/01/25 06:00 [medline]
PHST- 2022/08/30 22:14 [entrez]
AID - S1544-3191(22)00273-4 [pii]
AID - 10.1016/j.japh.2022.08.002 [doi]
PST - ppublish
SO  - J Am Pharm Assoc (2003). 2023 Jan-Feb;63(1):169-172. doi: 
      10.1016/j.japh.2022.08.002. Epub 2022 Aug 5.