ArticleCMAJ open
Amoxicillin oral provocation challenge in a primary care clinic: a descriptive analysis.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- A systematic review and meta-analysis of interventions to delabel low-risk penicillin allergies with consideration for sex and gender.British journal of clinical pharmacology · 2025Pooled it
- Delabelling suspected amoxicillin allergy in pediatric patients using oral challenge: a retrospective study from Northwestern Ontario.European journal of pediatrics · 2026Article
- Epicutaneous and Drug Provocation Testing in Severe Cutaneous Adverse Reactions: A 20-Year Single-Centre Experience.Contact dermatitis · 2026Article
- Penicillin allergies and community antibiotic prescriptions: A secondary analysis of prescribing choices in six family medicine clinics in southern Ontario, 2018-2019.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2026Article
- Healthcare professionals' experiences of de-labelling erroneous penicillin allergy records in general practice: a qualitative study.BJGP open · 2025Article
- How to Define and Manage Low-Risk Drug Allergy Labels.The journal of allergy and clinical immunology. In practice · 2024Review
- Beta-Lactam Allergy De-labeling in a Pediatric Hospital.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- Long waitlists for outpatient drug allergy referrals: An Australian tertiary centre experience.The World Allergy Organization journal · 2024Article
- Article
- Penicillin allergy delabelling of patients at risk of sexually transmitted infections in primary care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- Use of a beta-lactam graded challenge process for inpatients with self-reported penicillin allergies at an academic medical center.Frontiers in allergy · 2023Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPenicillin is the most frequently reported drug allergen; however, most of these allergies are not true allergies and do not justify the prescription of alternative, less effective and more expensive antibiotic drugs. We aimed to show that patients at low risk of amoxicillin allergy can safely and efficiently undergo oral provocation challenge (OPC) by their primary care physician.
methodsIn this descriptive analysis, we conducted a retrospective chart review of all primary care patients who had undergone OPC from November 2017 to October 2019 in the Amoxicillin Allergy Clinic at the North Perth Family Health Team, Listowel, Ontario. Eligibility for OPC among patients 18 months and older was determined through review of a self-reported patient intake form asking about symptoms, onset, duration, history and family history of allergic reactions, as well as the patient's electronic medical record. Patients were considered to be at low risk of true penicillin allergy if there was no history of anaphylaxis or severe cutaneous reactions. Those with low-risk allergic reactions returned for testing with an OPC to amoxicillin. We collected data on clinical characteristics, antibiotic exposure, parental drug allergy, response to OPC and wait time from referral. We used
resultsIn total, we included 99 patients (mean age 28.3, standard deviation [SD] 21.2 yr); 72 (73%) were female. Of those tested, 97% (
interpretationOral provocation challenge presents a safe and accessible opportunity for primary care providers to address erroneous allergy labels to penicillin and related drugs within the primary care office setting. There could be positive public health implications if OPC to penicillin drugs is implemented in primary care.
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