Status:

NOT_YET_RECRUITING

Evaluating the Feasibility of High-volume, Low-risk Penicillin Allergy De-labelling to Maximise Efficiency in a Resource-limited Setting

Lead Sponsor:

University Hospital Southampton NHS Foundation Trust

Conditions:

Penicillin Allergy

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

Plenty of studies have now established the safety of low-risk penicillin allergy de-labelling, but few have addressed how to organise de-labelling at the clinic level. This study will test the real wo...

Detailed Description

Participants with a penicillin allergy label will be invited to take part in the study, having been referred to the service by their hospital team. Based on the information provided with the referral,...

Eligibility Criteria

Inclusion

  • Penicillin allergy label
  • Age ≥18
  • Registered as a patient with University Hospital Southampton NHS Foundation Trust (with a UHS medical record)
  • Able and willing to consent to penicillin de-labelling

Exclusion

  • Penicillin allergy previously confirmed via positive blood, skin, BAT or challenge testing
  • PEN-FAST score \>2 (indicating a moderate or high risk of a positive challenge)
  • Anaphylaxis, angioedema, wheeze, shortness of breath or suspected hypotension linked to treatment with penicillin
  • Received treatment in hospital for a reaction linked to penicillin (unless already an inpatient at onset)
  • Itchy or urticarial rash within 1 hour of starting a new course of treatment with penicillin
  • Severe cutaneous adverse reaction (SCAR) linked to penicillin exposure (e.g. SJS/TEN, DRESS), including symptoms suggestive of SCAR without a formal diagnosis (e.g. skin blistering or peeling, mucosal involvement)
  • History of other serious, non-immediate reactions linked to penicillin (e.g. haemolytic anaemia, transaminitis, nephritis)
  • Currently pregnant or breastfeeding
  • Poorly controlled asthma
  • Severe COPD
  • Severe or critical aortic stenosis
  • Clinically unstable secondary to other organ failure
  • Unwell or unstable on the day of proposed penicillin challenge (including acute febrile illness)
  • Prescribed other antibiotics on the day of proposed challenge, unless taken as a long-term treatment/prophylaxis

Key Trial Info

Start Date :

October 1 2024

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

October 1 2025

Estimated Enrollment :

36 Patients enrolled

Trial Details

Trial ID

NCT06532448

Start Date

October 1 2024

End Date

October 1 2025

Last Update

August 5 2024

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