Augustino Angela, Alvarez Kristin S, Kassem Layla, Roy Lonnie, Termulo Cesar, Smartt Jillian, Sparks Madeline, Mercadel Candice, Chow Timothy G
Pharmacy, Parkland Health, Dallas, Texas.
Center of Innovation and Value at Parkland, Parkland Health, Dallas, Texas.
J Allergy Clin Immunol Pract. 2024 Dec;12(12):3337-3345.e2. doi: 10.1016/j.jaip.2024.08.029. Epub 2024 Sep 7.
Documented penicillin allergies are associated with increased morbidity, increased hospital stay, and an increase in resistant infections. Penicillin allergy evaluations using a direct oral challenge with or without skin testing has been recommended as a delabeling strategy for patients with penicillin reaction histories. Barriers for achieving equitable access, however, exist. Understanding patient perceptions regarding their penicillin allergy across diverse populations is crucial to mitigate potential obstacles to penicillin allergy testing (PAT) and the use of penicillin-like antibiotics after delabeling.
The objective of this study was to gather perceptions of patients delabeled of their penicillin allergy after testing through a PAT program.
Patients who underwent PAT and had a subsequent allergy removal due to a negative result were interviewed using closed and open-ended questions.
A total of 100 patient interviews were completed. Awareness of the risks associated with unnecessary penicillin avoidance and PAT was low. Initial concerns regarding PAT were common but were frequently alleviated with targeted education. Most patients undergoing testing reported a positive experience and would recommend PAT to others. A minority of patients continued to have discordant perceptions regarding their penicillin allergy label with mistrust in the negative result being a critical theme identified.
Future interventions increasing the awareness of penicillin allergy labels and the risks and benefits of PAT in the general population are needed and must consider health literacy levels, languages, and cultural contexts. Measures to offer PAT within a clinical setting that has built high levels of patient trust will likely achieve the greatest long-term success.
有记录的青霉素过敏与发病率增加、住院时间延长以及耐药感染增加有关。对于有青霉素过敏史的患者，推荐采用直接口服激发试验（无论是否进行皮肤试验）作为一种去除标签的策略。然而，实现公平获取存在障碍。了解不同人群对青霉素过敏的看法对于减轻青霉素过敏检测（PAT）以及去除标签后使用类青霉素抗生素的潜在障碍至关重要。
本研究的目的是收集通过PAT计划检测后去除青霉素过敏标签的患者的看法。
对接受PAT并因结果为阴性而随后去除过敏标签的患者，使用封闭式和开放式问题进行访谈。
共完成了100例患者访谈。对不必要避免使用青霉素和PAT相关风险的认识较低。对PAT的初始担忧很常见，但通过针对性教育通常会得到缓解。大多数接受检测的患者报告有积极的体验，并会向其他人推荐PAT。少数患者对其青霉素过敏标签仍有不一致的看法，对阴性结果的不信任是一个关键主题。
未来需要开展干预措施，提高普通人群对青霉素过敏标签以及PAT的风险和益处的认识，并且必须考虑健康素养水平、语言和文化背景。在建立了高度患者信任的临床环境中提供PAT的措施可能会取得最大的长期成功。
