SynthesisInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2023
The effectiveness of interventions that support penicillin allergy assessment and delabeling of adult and pediatric patients by nonallergy specialists: a systematic review and meta-analysis.
Synthesis in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- The cost-effectiveness of penicillin allergy testing: Evidence and gaps from a systematic review.PloS one · 2025Pooled it
- The cost-effectiveness of penicillin allergy assessment pathway (PAAP): a decision analysis.BMJ open · 2025Trial
- Penicillin Allergy Delabeling: Bridging the Evidence-Practice Gap in Antimicrobial Stewardship.Journal of general internal medicine · 2026Review
- Penicillin allergy delabeling in a German University Hospital-implementation in inpatient settings: the PenGuin Pilot Study.Infection · 2026Article
- Direct Oral Challenge for Penicillin Allergy: A Hospital Implementation Evaluation Via the International Network of Antibiotic Allergy Nations (iNAAN) Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Direct Oral Challenge for Penicillin Allergy: The International Network of Antibiotic Allergy Nations (iNAAN) Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Observational
- Outcomes of a penicillin allergy de-labelling implementation intervention in a UK hospital: a prospective, single centre, type 2 hybrid effectiveness-implementation study evaluated using mixed methods.Implementation science communications · 2026Article
- Performance of PEN-FAST and CEPH-FAST for Cephalosporin Allergy Delabeling.Clinical and translational allergy · 2026Article
- What are patients' and healthcare professionals' views on managing penicillin allergy? A qualitative evidence synthesis.JAC-antimicrobial resistance · 2026Review
- Clinical Outcome Associated With Beta-Lactam Allergy Labels in Hospitalized Patients in Belgium.Clinical and translational allergy · 2026Article
- The Clinical Impact of Antibiotic Allergy Labels on One-Year Outcomes of Solid Organ Transplant Recipients.Clinical transplantation · 2026Article
- A nurse-run, pharmacist-led outpatient penicillin allergy de-label clinic in the UK.JAC-antimicrobial resistance · 2026Article
- Widening access to penicillin allergy assessment in the United Kingdom-a proposed implementation plan for the National Health Service (NHS).JAC-antimicrobial resistance · 2026Review
- Penicillin allergy documentation in the UAE: 10-year trends and stewardship implications.Frontiers in medicine · 2026Article
- De-Labelling Penicillin Allergies in the Paediatric Emergency Department.Antibiotics (Basel, Switzerland) · 2025Review
- Using the Electronic Health Record to Facilitate Drug Allergy Delabeling.Current allergy and asthma reports · 2025Review
- Assessing a penicillin allergy de-labelling implementation intervention in a UK hospital: a process evaluation reporting healthcare workers' experiences.JAC-antimicrobial resistance · 2025Article
- The impact of drug allergy on planetary health and sustainability.Asia Pacific allergy · 2025Article
- [Antibiotic stewardship-an update : Ongoing development of an initiative].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPenicillin allergy records are often incorrect and may result in harm. We aimed to systematically review the effectiveness and safety of nonallergist health care worker delivery of penicillin allergy delabeling.
methodsWe searched EMBASE/MEDLINE/CINAHL (Ovid), PsycInfo, Web of Science, and Cochrane CENTRAL from inception to January 21, 2022 and unpublished studies and gray literature. The proportion of patients allergic to penicillin delabeled and harmed was calculated using random-effects models.
resultsOverall, 5019 patients were delabeled. Using allergy history alone, 14% (95% confidence interval [CI], 9-21%) of 4350 assessed patients were delabeled without reported harm. Direct drug provocation testing resulted in delabeling in 27% (95% CI, 18-37%) of 4207 assessed patients. Of the 1373 patients tested, 98% were delabeled (95% CI, 97-99%), and nonserious harm was reported in 1% (95% CI, 0-2%). Using skin testing, followed by drug provocation testing, 41% (95% CI, 24-59%) of 2890 assessed patients were delabeled. Of the 1294 tested patients, 95.0% (95% CI, 90-99%) were delabeled, and the reported harm was low (0%; (95% CI 0-1%).
conclusionPenicillin allergy delabeling by nonallergists is efficacious and safe. The proportion of assessed patients who can be delabeled increases with the complexity of testing method, but substantial numbers can be delabeled without skin testing.
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