Article ; Online: Parental perspective on penicillin allergy delabeling in a pediatric emergency department.
2023 Volume 131, Issue 1, Page(s) 82–88
Abstract: Background: Penicillin (PCN) allergy is frequently mislabeled and inaccurately diagnosed in children. Successful implementation of pediatric emergency department (PED) delabeling efforts requires parental understanding and willingness for children to be ...
| Abstract | Background: Penicillin (PCN) allergy is frequently mislabeled and inaccurately diagnosed in children. Successful implementation of pediatric emergency department (PED) delabeling efforts requires parental understanding and willingness for children to be delabeled as PCN-nonallergic. Objective: To describe the parental perspective on allergy delabeling in the PED for children identified as low risk for true PCN allergy. Methods: This is a cross-sectional survey of parents of children with documented PCN allergy presenting to a single tertiary-care PED. Parents were first approached to complete a PCN allergy identification questionnaire to stratify their child as high- or low-risk for true PCN allergy. Facilitators and barriers to PED-based oral challenge and delabeling were subsequently assessed by parents of low-risk children. Results: A total of 198 participants completed the PCN identification questionnaire. Of 198 children, 49 (25%) screened low risk for true PCN allergy. Of the 49 low-risk children, 29 (59%) parents were uncomfortable with a PED-based PCN oral challenge. Reasons include fear of allergic reaction (72%), availability of adequate alternative antibiotics (45%), and longer PED stay (17%). Reasons for willingness to delabel included PCN's low adverse effect profile (65%) and avoidance of antimicrobial resistance from alternative antibiotics (74%). Participants without a family history (FH) of PCN allergy were more comfortable with PED-based PCN oral challenge (60% vs 11%; P = .001) and delabeling (67% vs 37%; P = .04) compared with those with FH. Conclusion: Most parents of children with low-risk PCN allergy are uncomfortable with oral challenge or delabeling in the PED. Before implementing oral challenges in PEDs, efforts should be made to highlight the safety of oral challenging low-risk children, the benefits and risks of alternative antibiotics, and the minimal impact that FH has on PCN allergy. |
|---|---|
| MeSH term(s) | Child ; Humans ; Cross-Sectional Studies ; Penicillins/adverse effects ; Anti-Bacterial Agents ; Drug Hypersensitivity ; Emergency Service, Hospital ; Parents ; Hypersensitivity/drug therapy |
| Chemical Substances | Penicillins ; Anti-Bacterial Agents |
| Language | English |
| Publishing date | 2023-03-27 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 1228189-x |
| ISSN | 1534-4436 ; 0003-4738 ; 1081-1206 |
| ISSN (online) | 1534-4436 |
| ISSN | 0003-4738 ; 1081-1206 |
| DOI | 10.1016/j.anai.2023.03.023 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
Full text online
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Uh III Zs.136: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.