None listed
Conditions
Brief summary
More than two million Australians report an antibiotic or penicillin allergy. Patients’ reports are not always accurate, which may lead to them receiving second-line antibiotic therapies. It has been found that 85% of reported allergies are false and can be removed by testing: in fact, more than 95% of low-risk penicillin allergies. The International Network of Antibiotic Allergy Nations (iNAAN) is a health services program that seeks to improve access to direct oral penicillin challenge for Australian patients. This will reduce the burden and cost of antibiotic allergies in healthcare. At present, many of the patients carrying an antibiotic allergy label remain undiscovered with 50% of these patients not having access to vital testing. We seek to prospectively audit this clinical program to assess safety and the impact on reducing the burden of penicillin allergy in hospitalized patients and the subsequent effects on antibiotic prescribing and patient outcomes.
Interventions
EFFECTIVENESS: National (pre-dominantly Australian) and International prospective cohort study/registry and audit of health services' routine/standard of care antibiotic allergy assessment and direct oral penicillin challenge and delabelling programs.
Hospitalised participants with a penicillin allergy will be identified by site investigators. Patients with a penicillin allergy will undergo formal antibiotic allergy assessment using validated antibiotic allergy assessment tools and/or according
EFFECTIVENESS: National (pre-dominantly Australian) and International prospective cohort study/registry and audit of health services' routine/standard of care antibiotic allergy assessment and direct oral penicillin challenge and delabelling programs. Hospitalised participants with a penicillin allergy will be identified by site investigators. Patients with a penicillin allergy will undergo formal antibiotic allergy assessment using validated antibiotic allergy assessment tools and/or according to local health service antibiotic allergy protocols. Patients identified as having a low-risk penicillin allergy, according to the validated antibiotic allergy assessment tools, will be offered a direct oral penicillin challenge, which, if negative, will enable delabelling of the penicillin allergy. Patient demographic data (age, sex, ethnicity), medical co-morbidities, antibiotic allergy phenotype and penicillin oral challenge data (if performed) will be collected by the secure National Antibiotic Allergy Network (NAAN) smart-phone app with secure upload to the iNAAN REDCap database, hosted by BioGrid. The NAAN smart-phone app is accessible only by participating health service study teams. Data is entered into the NAAN smart-phone app by multi-disciplinary clinicians (Medical, Nursing, Pharmacy) who are part of the site project team. Additional data, including hospital admission data, antibiotic usage pre- and post- antibiotic allergy testing and antibiotic adverse events may also be entered into the REDCap database for up to 90 days post discharge. IMPLEMENTATION: At a minimum of three months following site activation and administration of the digital penicillin allergy toolkit, iNAAN clinicians and health services will receive bimonthly digitally delivered A&F (‘Health Service Report’) detailing local effectiveness and implementation outcomes of penicillin allergy assessment and delabeling. Additional optional education sessions will be facilitated by the study team and will be open to all investigators and stakeholders at participating health services throughout the study period.
Sponsors
Austin Health
Eligibility
Sex/Gender
All
Healthy volunteers
No
Inclusion criteria
Hospitalised inpatients reporting a penicillin allergy.
Exclusion criteria
Patients without a penicillin allergy label
Outcome results
None listed