Virtually supported penicillin allergy de-labelling during COVID-19.

Area of Science:

• Allergy and Immunology
• Digital Health
• Pharmacology

Background:

• Penicillin allergy is frequently misdiagnosed, leading to unnecessary avoidance of crucial antibiotics.
• Accurate penicillin allergy assessment is vital to prevent adverse health outcomes and reduce healthcare costs.
• Traditional oral challenges for penicillin allergy de-labeling can be a barrier, particularly with reduced in-person healthcare access.

Purpose of the Study:

• To evaluate the effectiveness of a virtually supported platform for penicillin allergy oral provocation challenges.
• To determine the feasibility of expediting penicillin de-labeling using telemedicine, especially during the COVID-19 pandemic.
• To assess the utility of virtual challenges for patients at low to moderate risk of immediate hypersensitivity.

Main Methods:

• A case series involving patients referred for penicillin allergy assessment in Vancouver.
• Virtual allergist consultations were used for initial risk stratification and decision-making.
• Virtually supervised oral amoxicillin provocation challenges were conducted during subsequent virtual visits.

Main Results:

• Twenty-three adult and pediatric patients successfully completed the virtual oral amoxicillin challenge.
• 100% of participants tolerated the amoxicillin challenge without any adverse reactions.
• The virtual challenge proved effective for penicillin allergy de-labeling across diverse patient groups.

Conclusions:

• Virtually supported penicillin allergy de-labeling is a viable and effective strategy.
• Telemedicine platforms can enhance the efficiency and accessibility of allergy de-labeling processes.
• Shared decision-making and risk stratification are key components of successful virtual allergy de-labeling.