Management of a surgical patient with a label of penicillin allergy: narrative review and consensus recommendations
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Management of a surgical patient with a label of penicillin allergy : narrative review and consensus recommendations. / Savic, L. C.; Khan, D. A.; Kopac, P.; Clarke, R. C.; Cooke, P. J.; Dewachter, P.; Ebo, D. G.; Garcez, T.; Garvey, L. H.; Guttormsen, A. B.; Hopkins, P. M.; Hepner, D. L.; Kolawole, H.; Krøigaard, M.; Laguna, J. J.; Marshall, S. D.; Mertes, P. M.; Platt, P. R.; Rose, M. A.; Sabato, V.; Sadleir, P. H.M.; Savic, S.; Takazawa, T.; Voltolini, S.; Volcheck, G. W.
In: British Journal of Anaesthesia, Vol. 123, No. 1, 2019, p. e82-e94.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Management of a surgical patient with a label of penicillin allergy
T2 - narrative review and consensus recommendations
AU - Savic, L. C.
AU - Khan, D. A.
AU - Kopac, P.
AU - Clarke, R. C.
AU - Cooke, P. J.
AU - Dewachter, P.
AU - Ebo, D. G.
AU - Garcez, T.
AU - Garvey, L. H.
AU - Guttormsen, A. B.
AU - Hopkins, P. M.
AU - Hepner, D. L.
AU - Kolawole, H.
AU - Krøigaard, M.
AU - Laguna, J. J.
AU - Marshall, S. D.
AU - Mertes, P. M.
AU - Platt, P. R.
AU - Rose, M. A.
AU - Sabato, V.
AU - Sadleir, P. H.M.
AU - Savic, S.
AU - Takazawa, T.
AU - Voltolini, S.
AU - Volcheck, G. W.
PY - 2019
Y1 - 2019
N2 - Unsubstantiated penicillin-allergy labels are common in surgical patients, and can lead to significant harm through avoidance of best first-line prophylaxis of surgical site infections and increased infection with resistant bacterial strains. Up to 98% of penicillin-allergy labels are incorrect when tested. Because of the scarcity of trained allergists in all healthcare systems, only a minority of surgical patients have the opportunity to undergo testing and de-labelling before surgery. Testing pathways can be modified and shortened in selected patients. A variety of healthcare professionals can, with appropriate training and in collaboration with allergists, provide testing for selected patients. We review how patients might be assessed, the appropriate testing strategies that can be used, and the minimum standards of safe testing.
AB - Unsubstantiated penicillin-allergy labels are common in surgical patients, and can lead to significant harm through avoidance of best first-line prophylaxis of surgical site infections and increased infection with resistant bacterial strains. Up to 98% of penicillin-allergy labels are incorrect when tested. Because of the scarcity of trained allergists in all healthcare systems, only a minority of surgical patients have the opportunity to undergo testing and de-labelling before surgery. Testing pathways can be modified and shortened in selected patients. A variety of healthcare professionals can, with appropriate training and in collaboration with allergists, provide testing for selected patients. We review how patients might be assessed, the appropriate testing strategies that can be used, and the minimum standards of safe testing.
KW - allergy
KW - drug provocation testing
KW - penicillin
KW - prophylaxis
KW - surgery
KW - surgical site infection
U2 - 10.1016/j.bja.2019.01.026
DO - 10.1016/j.bja.2019.01.026
M3 - Review
C2 - 30916014
AN - SCOPUS:85062617784
VL - 123
SP - e82-e94
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
SN - 0007-0912
IS - 1
ER -
ID: 223569431