Powell Neil, Upton Mathew, Kent Bridie, Sandoe Jonathan A T, Tonkin-Crine Sarah
Pharmacy Department, Royal Cornwall Hospital, Truro TR1 3LJ, UK.
School of Biomedical Sciences, University of Plymouth, Plymouth PL4 8AA, UK.
JAC Antimicrob Resist. 2025 Aug 13;7(4):dlaf144. doi: 10.1093/jacamr/dlaf144. eCollection 2025 Aug.
Penicillin allergy (penA) records are common, but true penA is rare. PenA records are associated with broad spectrum antibiotic prescribing and negative patient outcomes. We developed a behavioural intervention package to support inpatient penicillin allergy de-labelling (PADL) delivered by a multi-profession non-allergist workforce to remove incorrect penA records from medical and surgical adult inpatients in a UK hospital.
To explore the experiences, beliefs and concerns of patients who had been offered PADL.
Semi-structured interviews to explore the views of patients admitted to a medical or surgical ward with a penA record and offered PADL between June 2024 and October 2024. Inductive reflexive thematic analysis was used to analyse the data.
Twenty patients were interviewed. Patients that believed their penA to be incorrect and those that described their index reaction as mild were more likely to agree to testing. Patients considered hospital a safe place to be tested. Some patients thought being acutely unwell was not a barrier to testing, whereas others preferred an outpatient setting once discharged from hospital. De-labelled patients described having a good explanation of the risks and benefits of PADL, were grateful for the opportunity and trusted the healthcare worker and the PADL process.
PADL was well accepted by patients who described receiving a good explanation of the PADL process. Index reactions perceived as low severity (e.g. non-severe rashes) and/or doubtful of their penA (e.g. unaware they had a penA record) were more likely to accept PADL. Some who declined inpatient PADL would consider outpatient testing once recovered from their acute illness.
青霉素过敏（penA）记录很常见，但真正的青霉素过敏却很少见。青霉素过敏记录与广谱抗生素的开具以及不良患者结局相关。我们开发了一套行为干预方案，以支持由多专业非过敏专科医护人员进行的住院患者青霉素过敏标签去除（PADL），从而从英国一家医院的成年内科和外科住院患者中删除不正确的青霉素过敏记录。
探讨接受青霉素过敏标签去除（PADL）的患者的经历、信念和担忧。
采用半结构化访谈，以探究2024年6月至2024年10月期间入住内科或外科病房且有青霉素过敏记录并接受了青霉素过敏标签去除（PADL）的患者的观点。采用归纳反思主题分析法对数据进行分析。
共访谈了20名患者。认为自己的青霉素过敏记录不正确的患者以及将其首次过敏反应描述为轻微的患者更有可能同意进行检测。患者认为医院是进行检测的安全场所。一些患者认为急性不适并非检测的障碍，而另一些患者则更倾向于出院后在门诊进行检测。标签被去除的患者表示对青霉素过敏标签去除（PADL）的风险和益处有很好的解释，对获得的机会表示感激，并信任医护人员和青霉素过敏标签去除（PADL）流程。
青霉素过敏标签去除（PADL）得到了患者的广泛接受，患者表示对青霉素过敏标签去除（PADL）流程有很好的解释。被认为严重程度较低的首次过敏反应（如非严重皮疹）和/或对自己的青霉素过敏记录存疑的患者（如不知道自己有青霉素过敏记录）更有可能接受青霉素过敏标签去除（PADL）。一些拒绝住院期间进行青霉素过敏标签去除（PADL）的患者在急性疾病康复后会考虑门诊检测。
