Plenty of studies have now established the safety of low-risk penicillin allergy de-labelling, but few have addressed how to organise de-labelling at the clinic level. This study will test the real world practicalities of running a de-labelling clinic optimised for maximum patient volume. The sheer number of patients with a penicillin allergy label, in contrast to relatively few allergy centres, makes demonstrating that such an approach can work extremely important for future antimicrobial stewardship.
Penicillin allergy label
Age ≥18
Registered as a patient with University Hospital Southampton NHS Foundation Trust (with a UHS medical record)
Able and willing to consent to penicillin de-labelling
Penicillin allergy previously confirmed via positive blood, skin, BAT or challenge testing
PEN-FAST score >2 (indicating a moderate or high risk of a positive challenge)
Anaphylaxis, angioedema, wheeze, shortness of breath or suspected hypotension linked to treatment with penicillin
Received treatment in hospital for a reaction linked to penicillin (unless already an inpatient at onset)
Single group
Single dose low-risk penicillin challenge
Diagnostic testInitial screening to establish low risk allergy status followed by a single dose challenge using a standard penicillin dose. All challenges will be oral, conducted in a hospital setting and will be followed by a 1 hour monitoring period.
How can low-risk penicillin allergy de-labelling be delivered with maximal efficiency in a resource limited setting?
Successful operation of the high-volume clinic model, assessed via: 1. Number of patients reviewed and tested (if appropriate) within each allocated session 2. Evidence of acceptability to patients from feedback forms
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This trial is not recruiting at the moment. You can still explore other options:
