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ESCAPE-Allergy: Evaluating screening for children and adolescents with penicillin allergy

Kobi J Rischin1, Mona Mostaghim2, Arjun Rao1,3

  • 1School of Women's and Children's Heath, University of New South Wales, Sydney, New South Wales, Australia.

Journal of Paediatrics and Child Health
|July 29, 2021
PubMed

Insights

A new allergy assessment tool effectively evaluated penicillin allergy labels in children. This tool demonstrated high accuracy in identifying reactions and managing care, improving patient safety.

Area of Science:

  • Clinical immunology and allergy
  • Pediatric pharmacology
  • Patient safety research

Background:

  • Penicillin allergy labels are common in children, often inaccurate, leading to adverse health outcomes.
  • Underutilization of penicillin delabelling strategies and lack of pediatric-specific resources hinder accurate diagnosis.
  • Accurate penicillin allergy assessment is crucial for appropriate antibiotic use and patient safety in pediatric populations.

Purpose of the Study:

  • To evaluate the performance of a pediatric-adapted penicillin allergy assessment tool in a hospital setting.
  • To determine the tool's sensitivity, specificity, and acceptability among clinicians for pediatric penicillin allergy assessment.

Main Methods:

  • A pediatric-adapted penicillin allergy assessment tool was evaluated using an online survey.
  • Clinicians (doctors, nurses, pharmacists) assessed 10 hypothetical cases with varying penicillin reactions.
  • The tool's accuracy in assigning reaction phenotypes and recommending management was assessed.

Main Results:

  • The tool achieved 80.7% sensitivity for correct reaction phenotype assignment and 85.3% for appropriate management.
  • High sensitivity (95.6%) was observed for identifying immediate hypersensitivity reactions.
  • A majority of clinicians (73.3%) found the tool acceptable for use in practice.

Conclusions:

  • The pediatric-adapted penicillin allergy assessment tool demonstrated good overall performance and safety in a tertiary pediatric hospital.
  • The tool is effective in identifying immediate hypersensitivity reactions, supporting safe delabelling efforts.
  • Further research is needed to implement allergy assessment and delabelling programs for children.
Abstract

Keywords:
adverse effectantibacterial agentantimicrobial stewardshipchildrendiagnosisdrug hypersensitivity

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