Long Term Follow up after Penicillin Allergy De-labeling in Ambulatory Patients

Publication date: Available online 22 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Idit Lachover, Shoshan Sharon, Yossi Rosman, Keren Meir-Shafrir, Ronit Confino-Cohen
BackgroundUnverified penicillin allergy label has negative health implications. Toaddress this, several de-labeling methods have been proposed.ObjectiveTo appraise the long term outcomes of the penicillin allergy evaluation in ambulatory patients, focusing on subsequent use of penicillins in individuals found not allergic. A secondary objective was to examine the consistency between the evaluation's recommendations and the allergy label.MethodsA retrospective medical records review and phone survey were carried out in ambulatory patients that were evaluated for suspected penicillin allergy in our allergy unit. Patients with an uneventful oral challenge test (OCT) were interviewed regarding subsequent penicillins use. Medical records were examined for antibiotic prescriptions and purchases. The records were also investigated for existing/erased penicillin allergy label and its consistency with the allergy evaluation.ResultsSix hundred and thirty nine patients with an uneventful OCT were available for the survey. During a 56 month follow-up, 70% (447 patients) have used penicillins at least once. One hundred and ninety two patients (30%) did not use penicillins. The main reason for not using penicillins was lack of a clinical indication. Three hundred thirty five patients (51.22%) carried a penicillin allergy label in their electronic medical file in spite of an uneventful OCT.ConclusionPenicillin allergy annulling via OCT has proven to be effective. Most of the patients who previously avoided penicillins have re-used penicillins safely.