Management of a surgical patient with a label of penicillin allergy: narrative review and consensus recommendations

L. C. Savic, D. A. Khan, P. Kopac, R. C. Clarke, P. J. Cooke, P. Dewachter, D. G. Ebo, T. Garcez, L. H. Garvey, A. B. Guttormsen, P. M. Hopkins, D. L. Hepner, H. Kolawole, M. Krøigaard, J. J. Laguna, S. D. Marshall, P. M. Mertes, P. R. Platt, M. A. Rose, V. Sabato & 5 others P. H.M. Sadleir, S. Savic, T. Takazawa, S. Voltolini, G. W. Volcheck

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Unsubstantiated penicillin-allergy labels are common in surgical patients, and can lead to significant harm through avoidance of best first-line prophylaxis of surgical site infections and increased infection with resistant bacterial strains. Up to 98% of penicillin-allergy labels are incorrect when tested. Because of the scarcity of trained allergists in all healthcare systems, only a minority of surgical patients have the opportunity to undergo testing and de-labelling before surgery. Testing pathways can be modified and shortened in selected patients. A variety of healthcare professionals can, with appropriate training and in collaboration with allergists, provide testing for selected patients. We review how patients might be assessed, the appropriate testing strategies that can be used, and the minimum standards of safe testing.

Original languageEnglish
Pages (from-to)e82-e94
JournalBritish Journal of Anaesthesia
Volume123
Issue number1
DOIs
Publication statusPublished - 1 Jul 2019

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Penicillins
Hypersensitivity
Delivery of Health Care
Surgical Wound Infection
Infection
Allergists

Cite this

Savic, L. C., Khan, D. A., Kopac, P., Clarke, R. C., Cooke, P. J., Dewachter, P., ... Volcheck, G. W. (2019). Management of a surgical patient with a label of penicillin allergy: narrative review and consensus recommendations. British Journal of Anaesthesia, 123(1), e82-e94. https://doi.org/10.1016/j.bja.2019.01.026
Savic, L. C. ; Khan, D. A. ; Kopac, P. ; Clarke, R. C. ; Cooke, P. J. ; Dewachter, P. ; Ebo, D. G. ; Garcez, T. ; Garvey, L. H. ; Guttormsen, A. B. ; Hopkins, P. M. ; Hepner, D. L. ; Kolawole, H. ; Krøigaard, M. ; Laguna, J. J. ; Marshall, S. D. ; Mertes, P. M. ; Platt, P. R. ; Rose, M. A. ; Sabato, V. ; Sadleir, P. H.M. ; Savic, S. ; Takazawa, T. ; Voltolini, S. ; Volcheck, G. W. / Management of a surgical patient with a label of penicillin allergy : narrative review and consensus recommendations. In: British Journal of Anaesthesia. 2019 ; Vol. 123, No. 1. pp. e82-e94.
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abstract = "Unsubstantiated penicillin-allergy labels are common in surgical patients, and can lead to significant harm through avoidance of best first-line prophylaxis of surgical site infections and increased infection with resistant bacterial strains. Up to 98{\%} of penicillin-allergy labels are incorrect when tested. Because of the scarcity of trained allergists in all healthcare systems, only a minority of surgical patients have the opportunity to undergo testing and de-labelling before surgery. Testing pathways can be modified and shortened in selected patients. A variety of healthcare professionals can, with appropriate training and in collaboration with allergists, provide testing for selected patients. We review how patients might be assessed, the appropriate testing strategies that can be used, and the minimum standards of safe testing.",
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Savic, LC, Khan, DA, Kopac, P, Clarke, RC, Cooke, PJ, Dewachter, P, Ebo, DG, Garcez, T, Garvey, LH, Guttormsen, AB, Hopkins, PM, Hepner, DL, Kolawole, H, Krøigaard, M, Laguna, JJ, Marshall, SD, Mertes, PM, Platt, PR, Rose, MA, Sabato, V, Sadleir, PHM, Savic, S, Takazawa, T, Voltolini, S & Volcheck, GW 2019, 'Management of a surgical patient with a label of penicillin allergy: narrative review and consensus recommendations' British Journal of Anaesthesia, vol. 123, no. 1, pp. e82-e94. https://doi.org/10.1016/j.bja.2019.01.026

Management of a surgical patient with a label of penicillin allergy : narrative review and consensus recommendations. / Savic, L. C.; Khan, D. A.; Kopac, P.; Clarke, R. C.; Cooke, P. J.; Dewachter, P.; Ebo, D. G.; Garcez, T.; Garvey, L. H.; Guttormsen, A. B.; Hopkins, P. M.; Hepner, D. L.; Kolawole, H.; Krøigaard, M.; Laguna, J. J.; Marshall, S. D.; Mertes, P. M.; Platt, P. R.; Rose, M. A.; Sabato, V.; Sadleir, P. H.M.; Savic, S.; Takazawa, T.; Voltolini, S.; Volcheck, G. W.

In: British Journal of Anaesthesia, Vol. 123, No. 1, 01.07.2019, p. e82-e94.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Management of a surgical patient with a label of penicillin allergy

T2 - narrative review and consensus recommendations

AU - Savic, L. C.

AU - Khan, D. A.

AU - Kopac, P.

AU - Clarke, R. C.

AU - Cooke, P. J.

AU - Dewachter, P.

AU - Ebo, D. G.

AU - Garcez, T.

AU - Garvey, L. H.

AU - Guttormsen, A. B.

AU - Hopkins, P. M.

AU - Hepner, D. L.

AU - Kolawole, H.

AU - Krøigaard, M.

AU - Laguna, J. J.

AU - Marshall, S. D.

AU - Mertes, P. M.

AU - Platt, P. R.

AU - Rose, M. A.

AU - Sabato, V.

AU - Sadleir, P. H.M.

AU - Savic, S.

AU - Takazawa, T.

AU - Voltolini, S.

AU - Volcheck, G. W.

PY - 2019/7/1

Y1 - 2019/7/1

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KW - allergy

KW - drug provocation testing

KW - penicillin

KW - prophylaxis

KW - surgery

KW - surgical site infection

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