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Antibiotics 2018, 7(3), 71; https://doi.org/10.3390/antibiotics7030071

Patient and Prescriber Views of Penicillin Allergy Testing and Subsequent Antibiotic Use: A Rapid Review

1
Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
2
Department of Primary and Interdisciplinary care, University of Antwerp, Campus “Drie Eiken”, Gebouw R, Universiteitsplein 1, B-2610 WILRIJK Antwerpen, Belgium
3
Leeds Institute of Health Sciences’, Faculty of Medicine and Health, University of Leeds, Worsley Building, Clarendon Way, Leeds LS2 9LU, UK
4
Dental Translational and Clinical Research Unit, Faculty of Medicine and Health, University of Leeds, Worsley Building, Clarendon Way, Leeds LS2 9LU, UK
5
Healthcare Associated Infection Group, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds LS13EX, UK
6
NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Wellington Square, Oxford OX1 2JD, UK
*
Author to whom correspondence should be addressed.
Received: 21 June 2018 / Revised: 27 July 2018 / Accepted: 31 July 2018 / Published: 6 August 2018
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Abstract

About 10% of U.K. patients believe that they are allergic to penicillin and have a “penicillin allergy label” in their primary care health record. However, around 90% of these patients may be mislabelled. Removing incorrect penicillin allergy labels can help to reduce unnecessary broad-spectrum antibiotic use. A rapid review was undertaken of papers exploring patient and/or clinician views and experiences of penicillin allergy testing (PAT) services and the influences on antibiotic prescribing behaviour in the context of penicillin allergy. We reviewed English-language publications published up to November 2017. Limited evidence on patients’ experiences of PAT highlighted advantages to testing as well as a number of concerns. Clinicians reported uncertainty about referral criteria for PAT. Following PAT and a negative result, a number of clinicians and patients remained reluctant to prescribe and consume penicillins. This appeared to reflect a lack of confidence in the test result and fear of subsequent reactions to penicillins. The findings suggest lack of awareness and knowledge of PAT services by both clinicians and patients. In order to ensure correct penicillin allergy diagnosis, clinicians and patients need to be supported to use PAT services and equipped with the skills to use penicillins appropriately following a negative allergy test result. View Full-Text
Keywords: penicillin allergy; antibiotic stewardship; prescribing; antibiotic resistance penicillin allergy; antibiotic stewardship; prescribing; antibiotic resistance
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Wanat, M.; Anthierens, S.; Butler, C.C.; Wright, J.M.; Dracup, N.; Pavitt, S.H.; Sandoe, J.A.T.; Tonkin-Crine, S. Patient and Prescriber Views of Penicillin Allergy Testing and Subsequent Antibiotic Use: A Rapid Review. Antibiotics 2018, 7, 71.

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