{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:45:03Z","timestamp":1787849103954,"version":"build-2784847793"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To develop a transferable process, CATALYST (challenging antibiotic allergystatus), to assess and challenge penicillin allergy status of inpatients within an NHS Foundation Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multidisciplinary team (MDT) steering group reviewed existing literature and protocols enabling penicillin allergy assessment, challenge and de-labelling. Using this, they identified five key steps forming the basis of CATALYST: clinical assessment of the nature of allergy; inclusion\/exclusion criteria; consent; direct oral penicillin challenge; and removal of allergy label. A pharmacist-led pilot was conducted to assess the process, during which a continuous PDSA (plan-do-study-act) cycle was observed. This included formally auditing endpoint data such as accuracy of allergy status in medical records post-intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CATALYST was successfully developed with key resources produced to support clinicians. It was piloted in 304 patients, with 172 patients excluded and 132 successful allergy challenges. There was one incident of an adverse event (acute kidney injury) in the 132 successful patients, which occurred as a delayed reaction following 22 days of penicillin therapy. Only 64% of permanent records (held by GP) were appropriately updated when audited at the end of the pilot.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CATALYST is a transferable process to facilitate safe assessment, challenge and removal of spurious penicillin allergy labels. Handover between care sectors forms a key element of allergy removal to ensure all records are updated and work is needed to ensure this process is done effectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkad081","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T07:46:31Z","timestamp":1678347991000},"page":"1241-1244","source":"Crossref","is-referenced-by-count":21,"title":["CATALYST: challenging antibiotic allergy status"],"prefix":"10.1093","volume":"78","author":[{"given":"Joseph","family":"Brayson","sequence":"first","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Pharmacy department, Rake Lane , North Shields, NE29 8NH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Barrett","sequence":"additional","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Pharmacy department, Rake Lane , North Shields, NE29 8NH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasim","family":"Baqir","sequence":"additional","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Pharmacy department, Rake Lane , North Shields, NE29 8NH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Campbell","sequence":"additional","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Pharmacy department, Rake Lane , North Shields, NE29 8NH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamsin","family":"Oswald","sequence":"additional","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Microbiology department, Rake Lane , North Shields, NE29 8NH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Ellis","sequence":"additional","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, Northumbria Specialist Emergency Care Hospital, Northumbria Way, Infectious Diseases\/Acute Medicine, Rake Lane , North Shields, NE23 6NZ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Premchand","sequence":"additional","affiliation":[{"name":"Northumbria Healthcare NHS Foundation Trust, Northumbria Specialist Emergency Care Hospital, Northumbria Way, Infectious Diseases\/Acute Medicine, Rake Lane , North Shields, NE23 6NZ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"key":"2023050300195507100_dkad081-B1","doi-asserted-by":"crossref","first-page":"j3402","DOI":"10.1136\/bmj.j3402","article-title":"Penicillin allergy\u2014getting the label right","volume":"358","author":"Drug and Therapeutics Bulletin","year":"2017","journal-title":"BMJ"},{"key":"2023050300195507100_dkad081-B2","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1093\/jac\/dkz127","article-title":"\u2018Warning: allergic to penicillin\u2019: association between penicillin allergy status in 2.3 million NHS general practice electronic health records, antibiotic prescribing and health outcomes","volume":"74","author":"West","year":"2019","journal-title":"J Antimicrob Chemother"},{"key":"2023050300195507100_dkad081-B3","doi-asserted-by":"crossref","first-page":"k2400","DOI":"10.1136\/bmj.k2400","article-title":"Risk of methicillin resistant Staphylococcus aureus and Clostridium difficile in patients with a documented penicillin allergy: population based matched cohort study","volume":"361","author":"Blumenthal","year":"2018","journal-title":"BMJ"},{"key":"2023050300195507100_dkad081-B4","author":"The Pharmaceutical Journal","year":"2020"},{"key":"2023050300195507100_dkad081-B5","doi-asserted-by":"crossref","first-page":"3262","DOI":"10.1016\/j.jaip.2022.08.027","article-title":"Penicillin allergy label is associated with worse clinical outcomes in bacterial pneumonia","volume":"10","author":"Kaminsky","year":"2022","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2023050300195507100_dkad081-B6","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1093\/cid\/ciaa194","article-title":"Penicillin allergy testing is cost-saving: an economic evaluation study","volume":"72","author":"Sousa-Pinto","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2023050300195507100_dkad081-B7","article-title":"Safety and efficacy of de-labelling penicillin allergy in adults using direct oral challenge: a systematic review","volume":"27","author":"Cooper","year":"2021","journal-title":"JAC Antimicrob Resist"},{"key":"2023050300195507100_dkad081-B8","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2500\/aap.2019.40.4184","article-title":"Direct oral amoxicillin challenge without preliminary skin testing in adult patients with allergy and at low risk with reported penicillin allergy","volume":"40","author":"Kuruvilla","year":"2019","journal-title":"Allergy Asthma Proc"},{"key":"2023050300195507100_dkad081-B9","doi-asserted-by":"crossref","first-page":"2475","DOI":"10.1093\/jac\/dkz229","article-title":"Is direct oral amoxicillin challenge a viable approach for \u2018low-risk\u2019 patients labelled with penicillin allergy?","volume":"74","author":"Krishna","year":"2019","journal-title":"J Antimicrob Chemother"},{"key":"2023050300195507100_dkad081-B10","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1093\/jac\/dkz082","article-title":"Evaluation of a pharmacist-led penicillin allergy de-labelling ward round: a novel antimicrobial stewardship intervention","volume":"74","author":"Devchand","year":"2019","journal-title":"J Antimicrob Chemother"},{"key":"2023050300195507100_dkad081-B11","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1001\/jamainternmed.2020.0403","article-title":"Development and validation of a penicillin allergy clinical decision rule","volume":"180","author":"Trubiano","year":"2020","journal-title":"JAMA Intern Med"},{"key":"2023050300195507100_dkad081-B12","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.jaip.2018.07.048","article-title":"Pathways to improved antibiotic allergy and antimicrobial stewardship practice: the validation of a beta-lactam antibiotic allergy assessment tool","volume":"7","author":"Devchand","year":"2019","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2023050300195507100_dkad081-B13","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1111\/cea.13878","article-title":"An algorithm for safe de-labelling of antibiotic allergy in adult hospital in-patients","volume":"51","author":"Sneddon","year":"2021","journal-title":"Clin Exp Allergy"},{"key":"2023050300195507100_dkad081-B14","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/j.jaip.2022.08.052","article-title":"Comparative effectiveness, safety and real-world outcomes of a nurse-led, protocol-driven penicillin allergy evaluation from the Hong Kong drug allergy de-labelling initiative (HK-DADI)","volume":"11","author":"Kan","year":"2022","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2023050300195507100_dkad081-B15","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1111\/cea.14217","article-title":"BSACI guideline for the set-up of penicillin allergy de-labelling services by non-allergists working in a hospital setting","volume":"52","author":"Savic","year":"2022","journal-title":"Clin Exp Allergy"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/5\/1241\/50149010\/dkad081.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/78\/5\/1241\/50149010\/dkad081.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T20:20:41Z","timestamp":1683058841000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/78\/5\/1241\/7091370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,28]]},"references-count":15,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3,28]]},"published-print":{"date-parts":[[2023,5,3]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkad081","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,5,3]]},"published":{"date-parts":[[2023,3,28]]}}}