The Safety and Efficacy of an Oral Penicillin Challenge Program in Cancer Patients: A Multicenter Pilot Study

Jason A Trubiano, Olivia Smibert, Abby Douglas, Misha Devchand, Belinda Lambros, Natasha E Holmes, Kyra Y Chua, Elizabeth J Phillips, Monica A Slavin, Jason A Trubiano, Olivia Smibert, Abby Douglas, Misha Devchand, Belinda Lambros, Natasha E Holmes, Kyra Y Chua, Elizabeth J Phillips, Monica A Slavin

Abstract

Antibiotic allergies are reported by up to 1 in 4 cancer patients, almost 50% of which are considered low risk and precede the cancer diagnosis. We demonstrate the successful and safe implementation of a pilot oral penicillin challenge program for cancer patients with low-risk penicillin allergies, increasing the use of penicillin and narrow-spectrum beta-lactams post-testing.

Keywords: beta-lactam allergy; immunocompromised host; oral challenge; oral provocation; penicillin allergy.

Figures

Figure 1.
Figure 1.
Selection algorithm for oral penicillin rechallenge program. aDrug-induced liver injury was defined as ≥5× the upper limit of normal (ULN) for alanine aminotransferase (ALT), ≥2× the ULN for alkaline phosphatase, or ≥3× the ULN for ALT with bilirubin ≥2 ULN. bA nonimmune adverse drug reaction, such as nausea or vomiting. Abbreviations: ICU, intensive care unit; ID, infectious diseases; MET, medical emergency team.

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Source: PubMed

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