Honda Ryoko, Ishikawa Kazuhiro, Ozawa Hiroki, Matsumoto-Takahashi Emilie Louise Akiko, Mori Nobuyoshi
St. Luke's International Hospital, Tokyo, Japan.
St. Luke's International Hospital, Tokyo, Japan.
J Infect Chemother. 2025 Jan;31(1):102526. doi: 10.1016/j.jiac.2024.09.015. Epub 2024 Sep 20.
It has been reported that 95 % of patients labeled as penicillin-allergic may be mislabeled. However, the process of delabeling has not advanced due to a shortage of allergy specialists capable of conducting accurate assessments. To address this issue, The Antibiotics Allergy Assessment Tool (AAAT) has been proposed as a tool to evaluate patients who can be delabeled by non-specialists.
This study aims to identify patients who can be delabeled and to evaluate patients who are likely to be delabeled using AAAT.
Patients admitted to the hospital between January 1, 2017, and December 31, 2021, with documented penicillin allergy labels were included in the study. Patients who demonstrated tolerance to labeled antibiotics or were labeled without explicit allergy declarations were defined as delabeling. Subsequently, patients who did not meet the criteria for delabeling were evaluated for their potential to be delabeled using the AAAT, retrospectively.
530 patients were selected, of which 62 (11.7 %) were delabeled. The AAAT evaluation of the remaining patients indicated that at least an additional 137 (25.8 %) patients could potentially be delabeled.
The use of AAAT demonstrated the potential to delabel approximately third as many patients without the need for specialist evaluation. To promote broader delabeling efforts in the future, prospective studies should investigate the safety and effectiveness of evaluation tools such as the AAAT.
据报道，被标记为青霉素过敏的患者中有95%可能被错误标记。然而，由于缺乏能够进行准确评估的过敏专科医生，取消标记的进程一直没有进展。为了解决这个问题，抗生素过敏评估工具（AAAT）已被提议作为一种由非专科医生评估可取消标记患者的工具。
本研究旨在识别可取消标记的患者，并使用AAAT评估可能被取消标记的患者。
纳入2017年1月1日至2021年12月31日期间入院且有青霉素过敏标记记录的患者。对标记抗生素表现出耐受性或标记时无明确过敏声明的患者被定义为可取消标记。随后，对不符合取消标记标准的患者使用AAAT进行回顾性评估，以确定其取消标记的可能性。
共选取530例患者，其中62例（11.7%）被取消标记。对其余患者的AAAT评估表明，至少还有137例（25.8%）患者可能被取消标记。
使用AAAT显示了无需专科评估即可为约三分之一的患者取消标记的潜力。为了在未来推动更广泛的取消标记工作，前瞻性研究应调查AAAT等评估工具的安全性和有效性。
