Summary of best evidence for antimicrobial allergy assessment in hospitalized patients_West China Medical Journal

Authors：

JI Dandan ¹ , WU Dong ² , HU Bijie ³ , ZHENG Zheng ¹ ,  YUAN Zheng ¹

1. Nursing Department, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China;
2. School of Nursing, Fudan University, Shanghai 200032, P. R. China;
3. Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China;

Corresponding?author：

YUAN Zheng, Email: yuan.zheng@zs-hospital.sh.cn

Keywords：

Antimicrobial drugs; allergy assessment; nursing assessment; evidence summary; evidence-based nursing

DOI：

10.7507/1002-0179.202401119

Video：

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Objective To search for, assess, and summarize the best evidence for antimicrobial allergy assessment in hospitalized patients, so as to provide an evidence-based basis for clinical nursing practice. Methods UpToDate, BMJ Best Practice, National Guideline Clearinghouse, Guidelines International Network, Yimaitong, JBI Evidence Synthesis, Cochrane Library, CINAHL, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Data, CQVIP, SinoMed, and related association websites were searched by computer for literature about clinical decisions, guidelines, expert consensuses, evidence summaries, systematic reviews and meta-analyses related to antimicrobial allergy assessment in hospitalized patients. The search time limit was from the establishment of the databases to September 2024. Two researchers trained in evidence-based practice screened the literature and evaluated the quality independently. Finally, the evidence-based research group extracted and integrated the evidence after discussion. Results Totally 8 articles were involved, including 6 guidelines and 2 systematic reviews. Finally, 25 pieces of best evidence were obtained across 6 aspects, including the importance of antimicrobial allergy assessment, the subjects of allergy assessment, the personnel conducting allergy assessment, the content of allergy assessment, the recording of allergy history, and assessment tips. Conclusion When applying and transforming evidence, medical staff should fully consider the actual clinical situation and explore the evaluation scheme of antimicrobial allergy history of hospitalized patients with local characteristics, to improve the accuracy of evaluation of antimicrobial allergy history of hospitalized patients, so as to strengthen the safety management of drug use and improve the level of rational drug use.

Citation： JI Dandan, WU Dong, HU Bijie, ZHENG Zheng, YUAN Zheng. Summary of best evidence for antimicrobial allergy assessment in hospitalized patients. West China Medical Journal, 2024, 39(9): 1443-1449. doi: 10.7507/1002-0179.202401119 Copy

1.	Stone CA, Trubiano J, Coleman DT, et al. The challenge of de-labeling penicillin allergy. Allergy, 2020, 75(2): 273-288.
2.	Zhou L, Dhopeshwarkar N, Blumenthal KG, et al. Drug allergies documented in electronic health records of a large healthcare system. Allergy, 2016, 71(9): 1305-1313.
3.	Sacco KA, Bates A, Brigham TJ, et al. Clinical outcomes following inpatient penicillin allergy testing: a systematic review and meta-analysis. Allergy, 2017, 72(9): 1288-1296.
4.	Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin “allergy” in hospitalized patients: a cohort study. J Allergy Clin Immunol, 2014, 133(3): 790-796.
5.	Mattingly TJ, Fulton A, Lumish RA, et al. The cost of self-reported penicillin allergy: a systematic review. J Allergy Clin Immunol Pract, 2018, 6(5): 1649-1654.
6.	Barlam TF, Cosgrove SE, Abbo LM, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis, 2016, 62(10): e51-e77.
7.	蔣子涵, 肖浩, 孟娟. 華西醫院住院患者“青霉素過敏史”相關問卷調查. 中華臨床免疫和變態反應雜志, 2022, 16(6): 589-594.
8.	肖浩, 張虹婷, 孟娟. “青霉素過敏史”主訴患者規范化青霉素過敏檢測結果. 中華臨床免疫和變態反應雜志, 2021, 15(4): 390-397.
9.	韋當, 王聰堯, 肖曉娟, 等. 指南研究與評價(AGREEⅡ)工具實例解讀. 中國循證兒科雜志, 2013, 8(4): 316-319.
10.	顧鶯, 張慧文, 周英鳳, 等. JBI 循證衛生保健中心關于不同類型研究的質量評價工具—系統評價的方法學質量評價. 護士進修雜志, 2018, 33(8): 701-703.
11.	胡雁, 郝玉芳. 循證護理學. 2 版. 北京: 人民衛生出版社, 2018: 75-76.
12.	王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015, 30(11): 964-967.
13.	Savic L, Ardern-Jones M, Avery A, et al. BSACI guideline for the set-up of penicillin allergy de-labelling services by non-allergists working in a hospital setting. Clin Exp Allergy, 2022, 52(10): 1135-1141.
14.	Pa?o-Pardo JR, Moreno Rodilla E, Cobo Sacristan S, et al. Management of patients with suspected or confirmed antibiotic allergy: executive summary of Guidelines from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Allergy and Clinical Immunology (SEAIC), the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Intensive Medicine and Coronary Care Units (SEMICYUC). J Investig Allergol Clin Immunol, 2023, 33(2): 95-101.
15.	Gonzalez-Estrada A, Radojicic C. Penicillin allergy: a practical guide for clinicians. Cleve Clin J Med, 2015, 82(5): 295-300.
16.	Broyles AD, Banerji A, Castells M. Practical guidance for the evaluation and management of drug hypersensitivity: general concepts. J Allergy Clin Immunol Pract, 2020, 8(9S): S3-S15.
17.	Jeimy S, Ben-Shoshan M, Abrams EM, et al. Practical guide for evaluation and management of beta-lactam allergy: position statement from the Canadian Society of Allergy and Clinical Immunology. Allergy Asthma Clin Immunol, 2020, 16(1): 95.
18.	Wijnakker R, van Maaren MS, Bode LGM, et al. The Dutch Working Party on Antibiotic Policy (SWAB) guideline for the approach to suspected antibiotic allergy. Clin Microbiol Infect, 2023, 29(7): 863-875.
19.	Powell N, Stephens J, Kohl D, et al. 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. Int J Infect Dis, 2023, 129: 152-161.
20.	Arnold A, Coventry LL, Foster MJ, et al. The burden of self-reported antibiotic allergies in health care and how to address it: a systematic review of the evidence. J Allergy Clin Immunol Pract, 2023, 11(10): 3133-3145.
21.	中華人民共和國國家衛生健康委員會. β 內酰胺類抗菌藥物皮膚試驗指導原則(2021 年版). 中國實用鄉村醫生雜志, 2021, 28(5): 1-4.
22.	DesBiens MT, Calderwood MS, Reigh EL. Expanding penicillin allergy evaluation in hospitalized patients. Am J Med, 2022, 135(8): 958-963.
23.	Arasaratnam RJ, Chow TG, Liu AY, et al. Penicillin allergy evaluation and health equity: a call to action. J Allergy Clin Immunol Pract, 2023, 11(2): 422-428.
24.	Blumenthal KG, Shenoy ES, Wolfson AR, et al. Addressing inpatient beta-lactam allergies: a multihospital implementation. J Allergy Clin Immunol Pract, 2017, 5(3): 616-625.
25.	Owens R, Sandoe J, Whyte AF, et al. A randomized evaluation of an antibiotic allergy assessment tool for supporting penicillin allergy de-labelling by non-allergists. Clin Exp Allergy, 2021, 51(9): 1246-1249.
26.	Olans RN, Olans RD, DeMaria A. The critical role of the staff nurse in antimicrobial stewardship--unrecognized, but already there. Clin Infect Dis, 2016, 62(1): 84-89.
27.	Thurman Johnson C, Ridge LJ, Hessels AJ. Nurse engagement in antibiotic stewardship programs: a scoping review of the literature. J Healthc Qual, 2023, 45(2): 69-82.
28.	Blumenthal KG, Peter JG, Trubiano JA, et al. Antibiotic allergy. Lancet, 2019, 393(10167): 183-198.
29.	Romano A, Atanaskovic-Markovic M, Barbaud A, et al. Towards a more precise diagnosis of hypersensitivity to beta-lactams - an EAACI position paper. Allergy, 2020, 75(6): 1300-1315.

1. Stone CA, Trubiano J, Coleman DT, et al. The challenge of de-labeling penicillin allergy. Allergy, 2020, 75(2): 273-288.
2. Zhou L, Dhopeshwarkar N, Blumenthal KG, et al. Drug allergies documented in electronic health records of a large healthcare system. Allergy, 2016, 71(9): 1305-1313.
3. Sacco KA, Bates A, Brigham TJ, et al. Clinical outcomes following inpatient penicillin allergy testing: a systematic review and meta-analysis. Allergy, 2017, 72(9): 1288-1296.
4. Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin “allergy” in hospitalized patients: a cohort study. J Allergy Clin Immunol, 2014, 133(3): 790-796.
5. Mattingly TJ, Fulton A, Lumish RA, et al. The cost of self-reported penicillin allergy: a systematic review. J Allergy Clin Immunol Pract, 2018, 6(5): 1649-1654.
6. Barlam TF, Cosgrove SE, Abbo LM, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis, 2016, 62(10): e51-e77.
7. 蔣子涵, 肖浩, 孟娟. 華西醫院住院患者“青霉素過敏史”相關問卷調查. 中華臨床免疫和變態反應雜志, 2022, 16(6): 589-594.
8. 肖浩, 張虹婷, 孟娟. “青霉素過敏史”主訴患者規范化青霉素過敏檢測結果. 中華臨床免疫和變態反應雜志, 2021, 15(4): 390-397.
9. 韋當, 王聰堯, 肖曉娟, 等. 指南研究與評價(AGREEⅡ)工具實例解讀. 中國循證兒科雜志, 2013, 8(4): 316-319.
10. 顧鶯, 張慧文, 周英鳳, 等. JBI 循證衛生保健中心關于不同類型研究的質量評價工具—系統評價的方法學質量評價. 護士進修雜志, 2018, 33(8): 701-703.
11. 胡雁, 郝玉芳. 循證護理學. 2 版. 北京: 人民衛生出版社, 2018: 75-76.
12. 王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015, 30(11): 964-967.
13. Savic L, Ardern-Jones M, Avery A, et al. BSACI guideline for the set-up of penicillin allergy de-labelling services by non-allergists working in a hospital setting. Clin Exp Allergy, 2022, 52(10): 1135-1141.
14. Pa?o-Pardo JR, Moreno Rodilla E, Cobo Sacristan S, et al. Management of patients with suspected or confirmed antibiotic allergy: executive summary of Guidelines from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Allergy and Clinical Immunology (SEAIC), the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Intensive Medicine and Coronary Care Units (SEMICYUC). J Investig Allergol Clin Immunol, 2023, 33(2): 95-101.
15. Gonzalez-Estrada A, Radojicic C. Penicillin allergy: a practical guide for clinicians. Cleve Clin J Med, 2015, 82(5): 295-300.
16. Broyles AD, Banerji A, Castells M. Practical guidance for the evaluation and management of drug hypersensitivity: general concepts. J Allergy Clin Immunol Pract, 2020, 8(9S): S3-S15.
17. Jeimy S, Ben-Shoshan M, Abrams EM, et al. Practical guide for evaluation and management of beta-lactam allergy: position statement from the Canadian Society of Allergy and Clinical Immunology. Allergy Asthma Clin Immunol, 2020, 16(1): 95.
18. Wijnakker R, van Maaren MS, Bode LGM, et al. The Dutch Working Party on Antibiotic Policy (SWAB) guideline for the approach to suspected antibiotic allergy. Clin Microbiol Infect, 2023, 29(7): 863-875.
19. Powell N, Stephens J, Kohl D, et al. 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. Int J Infect Dis, 2023, 129: 152-161.
20. Arnold A, Coventry LL, Foster MJ, et al. The burden of self-reported antibiotic allergies in health care and how to address it: a systematic review of the evidence. J Allergy Clin Immunol Pract, 2023, 11(10): 3133-3145.
21. 中華人民共和國國家衛生健康委員會. β 內酰胺類抗菌藥物皮膚試驗指導原則(2021 年版). 中國實用鄉村醫生雜志, 2021, 28(5): 1-4.
22. DesBiens MT, Calderwood MS, Reigh EL. Expanding penicillin allergy evaluation in hospitalized patients. Am J Med, 2022, 135(8): 958-963.
23. Arasaratnam RJ, Chow TG, Liu AY, et al. Penicillin allergy evaluation and health equity: a call to action. J Allergy Clin Immunol Pract, 2023, 11(2): 422-428.
24. Blumenthal KG, Shenoy ES, Wolfson AR, et al. Addressing inpatient beta-lactam allergies: a multihospital implementation. J Allergy Clin Immunol Pract, 2017, 5(3): 616-625.
25. Owens R, Sandoe J, Whyte AF, et al. A randomized evaluation of an antibiotic allergy assessment tool for supporting penicillin allergy de-labelling by non-allergists. Clin Exp Allergy, 2021, 51(9): 1246-1249.
26. Olans RN, Olans RD, DeMaria A. The critical role of the staff nurse in antimicrobial stewardship--unrecognized, but already there. Clin Infect Dis, 2016, 62(1): 84-89.
27. Thurman Johnson C, Ridge LJ, Hessels AJ. Nurse engagement in antibiotic stewardship programs: a scoping review of the literature. J Healthc Qual, 2023, 45(2): 69-82.
28. Blumenthal KG, Peter JG, Trubiano JA, et al. Antibiotic allergy. Lancet, 2019, 393(10167): 183-198.
29. Romano A, Atanaskovic-Markovic M, Barbaud A, et al. Towards a more precise diagnosis of hypersensitivity to beta-lactams - an EAACI position paper. Allergy, 2020, 75(6): 1300-1315.

West China Medical Journal

Summary of best evidence for antimicrobial allergy assessment in hospitalized patients

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