eprintid: 10086542 rev_number: 22 eprint_status: archive userid: 608 dir: disk0/10/08/65/42 datestamp: 2019-11-26 12:55:06 lastmod: 2021-11-23 01:19:48 status_changed: 2019-11-26 12:55:06 type: article metadata_visibility: show creators_name: Jani, Y title: Sustaining and spreading penicillin allergy de-labelling: a narrative review of the challenges for service delivery and patient safety ispublished: pub subjects: UCH divisions: UCL divisions: B02 divisions: C08 divisions: D10 divisions: G11 note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Many patients report allergies to penicillin, although in over 90% of these the label of penicillin allergy is shown to be incorrect following comprehensive testing. Inappropriate and inaccurate penicillin allergy labelling is a barrier to antimicrobial stewardship and can lead to patient harm. This review assesses an emergent evidence base and trend favouring delabelling using direct oral penicillin challenges following a stratified risk assessment of the likelihood and existence of true penicillin allergy, to identify and make recommendations for key components for implementation in standard practice. Research to date has focussed on the feasibility and clinical and financial outcomes of these direct delabelling strategies. There is a paucity of studies exploring the views and engagement of patients and healthcare professionals, and a gap in the evidence for prerequisites to safely deliver, sustain and spread the implementation of such services across health systems. date: 2020-03 date_type: published publisher: Wiley official_url: https://doi.org/10.1111/bcp.14190 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1722868 doi: 10.1111/bcp.14190 lyricists_name: Jani, Yogini lyricists_id: YHJAN61 actors_name: Jani, Yogini actors_name: Stacey, Thomas actors_id: YHJAN61 actors_id: TSSTA20 actors_role: owner actors_role: impersonator full_text_status: public publication: British Journal of Clinical Pharmacology volume: 86 number: 3 pagerange: 548-559 citation: Jani, Y; (2020) Sustaining and spreading penicillin allergy de-labelling: a narrative review of the challenges for service delivery and patient safety. British Journal of Clinical Pharmacology , 86 (3) pp. 548-559. 10.1111/bcp.14190 <https://doi.org/10.1111/bcp.14190>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10086542/1/Jani%20Allergy%20delabelling_narrative%20review_finalvNov2019_full.pdf