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抗菌药物管理药师进行的前瞻性风险分层和低风险青霉素过敏标签去除。

Proactive risk stratification and low-risk penicillin allergy delabeling by an antimicrobial stewardship pharmacist.

作者信息

Caturano Breana N, Bjork Lauren L, Lichtenberger Paola N, Temiño Viviana M

机构信息

Miami Veterans Affairs Healthcare System, Miami, FL, USA.

出版信息

Antimicrob Steward Healthc Epidemiol. 2024 May 27;4(1):e92. doi: 10.1017/ash.2024.91. eCollection 2024.

DOI:10.1017/ash.2024.91
PMID:38807930
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11131008/
Abstract

Penicillin (PCN) allergy delabeling is an important component of antimicrobial stewardship; however, widespread implementation has lagged. We found that most patients had low-risk PCN allergy histories eligible for delabeling without skin testing. Pharmacist-led risk stratification and drug challenge expanded access to delabeling independently from an Allergy/Immunology service.

摘要

青霉素（PCN）过敏标签去除是抗菌药物管理的重要组成部分；然而，广泛实施一直滞后。我们发现，大多数患者有符合标签去除条件的低风险青霉素过敏史，无需进行皮肤试验。由药剂师主导的风险分层和药物激发试验使患者无需通过过敏/免疫科服务就能独立获得标签去除的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11131008/f9fee86710e2/S2732494X24000913_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11131008/d91eb2ef73e1/S2732494X24000913_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11131008/f9fee86710e2/S2732494X24000913_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11131008/d91eb2ef73e1/S2732494X24000913_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a42/11131008/f9fee86710e2/S2732494X24000913_fig2.jpg

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本文引用的文献

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JAMA Intern Med. 2023 Sep 1;183(9):944-952. doi: 10.1001/jamainternmed.2023.2986.
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Drug allergy: A 2022 practice parameter update.药物过敏：2022年实践参数更新
J Allergy Clin Immunol. 2022 Dec;150(6):1333-1393. doi: 10.1016/j.jaci.2022.08.028. Epub 2022 Sep 17.
3
The Evolution of Our Understanding of Penicillin Allergy: 1942-2022.
青霉素过敏认识的演变：1942-2022 年。
J Allergy Clin Immunol Pract. 2023 Feb;11(2):405-413. doi: 10.1016/j.jaip.2022.09.006. Epub 2022 Sep 15.
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The challenge of de-labeling penicillin allergy.消除青霉素过敏标签的挑战。
Allergy. 2020 Feb;75(2):273-288. doi: 10.1111/all.13848. Epub 2019 May 26.
5
Evaluation and Management of Penicillin Allergy: A Review.青霉素过敏的评估与管理：综述
JAMA. 2019 Jan 15;321(2):188-199. doi: 10.1001/jama.2018.19283.
6
Direct oral amoxicillin challenge without preliminary skin testing in adult patients with allergy and at low risk with reported penicillin allergy.在报告有青霉素过敏的成年过敏患者且低风险患者中，不进行初步皮肤试验直接口服阿莫西林激发试验。
Allergy Asthma Proc. 2019 Jan 1;40(1):57-61. doi: 10.2500/aap.2019.40.4184.
7
Documentation of penicillin adverse drug reactions in electronic health records: inconsistent use of allergy and intolerance labels.电子健康记录中青霉素药物不良反应的记录：过敏和不耐受标签的使用不一致。
Intern Med J. 2017 Nov;47(11):1292-1297. doi: 10.1111/imj.13558.
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