Efficacy of the PEN-FAST score in a French cohort of patients with reported allergy to penicillins.

IF 3.3 Q2 ALLERGY
Frontiers in allergy Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI:10.3389/falgy.2024.1439698
Anatole Hanniet, Marc Puyraveau, Florence Castelain, Fabien Pelletier, François Aubin
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Abstract

Introduction: Various clinical decision-making tools for penicillin allergy have been developed to guide delabeling strategies.

Objective: To evaluate the penicillin allergy PEN-FAST decision score in a retrospective cohort of patients, adults and children, with penicillin-reported allergy.

Methods: This monocentric retrospective cohort included patients with penicillin-reported allergy. All patients underwent penicillin allergy testing using skin tests and/or drug challenge. The PEN-FAST score sensitivity, specificity, negative (NPV) and positive (PPV) predictive values, and the area under the receiver operating characteristics curve (AUC) were calculated.

Results: Two hundred and fourteen patients were included (64 children and 150 adults). Allergy was confirmed in 52 cases (24%). A PEN-FAST score <3 points showed a poor discrimination capacity for the whole population (AUC = 0.66; 95% CI: 0.58-0.75), while it demonstrated a better discrimination capacity in the adults group (AUC = 0.71; 95% CI: 0.63-0.80). The sensitivity to identify penicillin allergy using this cutoff of less than 3 points was 0.67 (95% CI: 0.52-0.80); specificity, 0.58 (95% CI: 0.48-0.68); PPV, 0.43 (95% CI: 0.32-0.55); and NPV, 0.78 (95% CI: 0.68-0.87).

Conclusions: Although our data confirm a rather good discrimination value of a PEN-FAST score <3 points, its low negative predictive value (78%) did not advocate for its use as an accurate, simple and cost-effective clinical decision-making tool to effectively reduce the number of penicillin skin tests required before direct oral challenge. Further studies are required to improve the predictive capacity of the PEN-FAST score.

PEN-FAST 评分在法国一组报告对青霉素过敏的患者中的疗效。
简介:针对青霉素过敏开发了各种临床决策工具,以指导脱标策略:在成人和儿童青霉素过敏患者的回顾性队列中评估青霉素过敏 PEN-FAST 决策评分:该单中心回顾性队列包括青霉素过敏的患者。所有患者都通过皮试和/或药物挑战进行了青霉素过敏测试。计算了 PEN-FAST 评分的敏感性、特异性、阴性预测值(NPV)和阳性预测值(PPV)以及接收者工作特征曲线下面积(AUC):共纳入 214 名患者(64 名儿童和 150 名成人)。其中 52 例(24%)确诊为过敏。PEN-FAST 评分 结论:尽管我们的数据证实了 PEN-FAST 评分具有相当好的区分价值
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
2.80
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