The Better Care Victoria Antibiotic Allergy Discovery and De-labelling Program commenced at Austin Health and Peter MacCallum Cancer Centre on the 21st of Jan 2019 with a mission to discover 4000 patients with an antibiotic allergy and directly "de-label" over 400 patients in a two year period.
The program aims to identify low risk patients reporting a penicillin allergy that can undergo successful oral challenge utilizing a published protocol or direct removal of the allergy from the record in the setting of a known reported drug side effect.
Chief Investigator - A/Prof Jason Trubiano
Program Lead - Dr Kyra Chua
Study commencement date: Jan 2019
Ethics approval: HREC/47585/AUSTIN/2018
Funding: Better Care Victoria (Further details at Department of Health website)
For details on the initial program- Trubiano et al. The Safety and Efficacy of an Oral Penicillin Rechallenge Program in Cancer Patients. Open Forum Infectious Diseases 2018
The results of the program were recently published in Clinical Infectious DIseases:
Chua K et al. The Penicillin Allergy Delabeling Program: A Multicenter Whole-of-Hospital Health Services Intervention and Comparative Effectiveness Study. Clin Infect Dis. 2020 Aug 5:ciaa653. doi: 10.1093/cid/ciaa653. Online ahead of print. : 32756983
Follow up impacts of the program on patient perceptions publushed in Journal of Clinical Immunology and Allergy In Practice:
Wilson A, Trubiano JA, Chua KYL. Patient perspectives on antibiotic allergy delabeling: Enablers and barriers. J Allergy Clin Immunol Pract. 2020 Nov-Dec;8(10):3637-3639.e5. doi: 10.1016/j.jaip.2020.07.017. Epub 2020 Jul 23.PMID: 32712200
The Antimicrobial Stewardship Clinical Care Standard (2020) references the work of CAAR in whole-of-hospital antibiotic allergy assessment - https://www.safetyandquality.gov.au/publications-and-resources/resource-library/antimicrobial-stewardship-clinical-care-standard-2020-publication
The program was also a recipient of a consumer engagement award from Austin Health.
Further information and resources are available
Included are associated publications from the program and awards of the program. The supplement to the Chua et al. paper gives complete guidance on protocols and program implementation.
The validated beta-lactam allergy assessment tool adapted from Devchand et al. J Allergy Clin Immunol Pract. 2019 Mar;7(3):1063-1065.e5
An information sheet for medical staff about the key factors around antibiotic allergy
A patient information sheet