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Related Experiment Video

Updated: Aug 5, 2025

Basophil Activation Test for Allergy Diagnosis
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CATALYST: challenging antibiotic allergy status.

Joseph Brayson1, Scott Barrett1, Wasim Baqir1

  • 1Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Pharmacy department, Rake Lane, North Shields, NE29 8NH, UK.

The Journal of Antimicrobial Chemotherapy
|March 28, 2023
PubMed
Summary
This summary is machine-generated.

The CATALYST process safely assesses and challenges penicillin allergy status in hospital patients. This method successfully de-labels many patients, but record-keeping requires improvement for effective allergy removal.

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Area of Science:

  • Clinical Medicine
  • Pharmacology
  • Patient Safety

Background:

  • Penicillin allergy labels are often inaccurate and lead to broad-spectrum antibiotic use.
  • A standardized process is needed to safely assess and de-label patients with penicillin allergy.
  • Current methods for allergy assessment and de-labelling lack transferability across healthcare settings.

Purpose of the Study:

  • To develop and pilot a transferable process, CATALYST (challenging antibiotic allergy status), for assessing and challenging penicillin allergy in inpatients.
  • To evaluate the safety and effectiveness of the CATALYST process in a hospital setting.
  • To identify key steps for successful penicillin allergy de-labelling and record updating.

Main Methods:

  • A multidisciplinary team developed the CATALYST process based on literature review and established protocols.
  • Key steps included clinical assessment, defining criteria, obtaining consent, direct oral challenge, and label removal.
  • A pharmacist-led pilot study utilized a plan-do-study-act cycle and audited medical record accuracy.

Main Results:

  • The CATALYST process was successfully developed and piloted in 304 patients, with 132 undergoing successful allergy challenges.
  • One adverse event (acute kidney injury) occurred as a delayed reaction in a patient receiving penicillin.
  • Only 64% of permanent general practitioner records were updated post-intervention, highlighting a handover issue.

Conclusions:

  • CATALYST provides a transferable framework for safely assessing, challenging, and removing inaccurate penicillin allergy labels.
  • Effective handover between care sectors is crucial for ensuring all patient records are updated post-de-labelling.
  • Further work is needed to optimize the record-updating process to ensure complete allergy removal across healthcare systems.