非过敏学家临床病房团队对青霉素过敏进行去标签处理的适当性。

IF 3.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-06-27 DOI:10.1016/j.clinme.2024.100225
Neil Powell, Shuayb Elkhalifa, Daniel Hearsey, Michael Wilcock, Jonathan Sandoe
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引用次数: 0

摘要

目的我们旨在评估临床团队进行青霉素过敏(PenA)评估的适当性,并审查这些患者随后接触青霉素的安全性:英国一家拥有 750 张病床的医院在 23 年 5 月 16 日至 23 年 8 月 14 日期间对需要使用抗生素的青霉素过敏住院患者的常规临床护理进行了机会性、前瞻性观察研究。为了评估管理的适当性,我们使用经过验证的抗生素过敏评估工具将开具青霉素处方的PenA患者分成了不同的风险类别:仅凭病史就符合去标签条件的(直接去标签;DDL)、符合直接口服挑战(DOC)条件的、高风险的或无法获得病史的:在 123 名有 PenA(或敏感性记录)并接触过青霉素的入院患者中,收集到了 50 名患者的数据。他们的 PenA 记录分类如下:符合 DDL 条件的 34 人(68%)、符合 DOC 条件的 11 人(22%)、高风险 4 人(8%)和无法获得病史的 1 人(2%)。14/50(28%)名患者的医疗记录中没有证据表明他们目前接受过 PenA 评估:结论:使用过敏风险工具,大多数有 PenA 记录的患者都适当地接触了青霉素。结论:大多数有 PenA 记录的患者都适当地接触了青霉素,但也有符合高风险标准的患者在工具排除的情况下接触了青霉素。在进行 PenA 评估时,需要进行适当的培训并建立相应的管理机构。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The appropriateness of penicillin allergy de-labelling by non-allergist clinical ward teams.

Objectives: We aimed to assess the appropriateness of penicillin allergy (PenA) assessment conducted by clinical teams and to review the safety of subsequent exposure of these patients to penicillin.

Methods: Opportunistic, prospective observational study of usual clinical care, between 16 May 2023 and 14 August 2023, of inpatients with a PenA and requiring antibiotics, in a 750-bed hospital in England. To assess the appropriateness of management, PenA patients prescribed penicillins were grouped into risk categories using a validated antibiotic allergy assessment tool: eligible for de-label on history alone (direct de-label; DDL), eligible for direct oral challenge (DOC), high risk or unable to obtain history.

Results: Of the 123 patients admitted with a PenA (or sensitivity record) and exposed to a penicillin, data were collected for 50. Their PenA records were grouped follows: eligible for DDL 34 (68%), eligible for DOC 11 (22%), high risk 4 (8%) and unable to obtain history 1 (2%). In 14/50 (28%) patients there was no evidence of a current PenA assessment in the medical notes.

Conclusions: Using the allergy risk tool, most patients with PenA records were exposed to penicillin appropriately. However, patients meeting high-risk criteria were also exposed to penicillin when the tool excluded them. PenA assessment needs to be carried out with appropriate training and governance structures in place.

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来源期刊
Clinical Medicine
Clinical Medicine 医学-医学:内科
CiteScore
7.20
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: Clinical Medicine is aimed at practising physicians in the UK and overseas and has relevance to all those managing or working within the healthcare sector. Available in print and online, the journal seeks to encourage high standards of medical care by promoting good clinical practice through original research, review and comment. The journal also includes a dedicated continuing medical education (CME) section in each issue. This presents the latest advances in a chosen specialty, with self-assessment questions at the end of each topic enabling CPD accreditation to be acquired. ISSN: 1470-2118 E-ISSN: 1473-4893 Frequency: 6 issues per year
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