{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T03:51:02Z","timestamp":1782100262523,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian J Rural Health"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Problem<\/jats:title>\n Programs that identify people with a low\u2010risk allergy who can be safely delabeled by a direct oral challenge have emerged but are mostly reported in tertiary centres. There is limited information in the rural setting where resources are more constrained.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n A medium\u2010sized rural health service in Victoria (Australia).<\/jats:p>\n <\/jats:sec>\n \n Key Measures for Improvement<\/jats:title>\n The outcome measure was the number of patients with a low\u2010risk penicillin allergy who completed a penicillin oral challenge.<\/jats:p>\n <\/jats:sec>\n \n Strategies for Change<\/jats:title>\n The penicillin oral challenge program developed considered four critical workflows: choice of allergy assessment tool, identifying those with a low\u2010risk penicillin allergy who were interested in an oral challenge, oral challenge supervision and communication of the outcome. These were tested through Plan, Do, Study, Act (PDSA) cycles.<\/jats:p>\n <\/jats:sec>\n \n Effects of Change<\/jats:title>\n Of 23 allergy assessment tools completed, fifteen revealed a low\u2010risk allergy (PEN\u2010FAST score 0, 1 or 2). Six people were not interested in the oral challenge and three did not have their interest recorded. Of the remaining six, four had an oral challenge (27%).<\/jats:p>\n <\/jats:sec>\n \n Lessons Learnt<\/jats:title>\n Utilizing teamwork and the broad skill set of generalist rural staff, this rural health service was able to complete a penicillin oral challenge for over 25% of inpatients with a low\u2010risk penicillin allergy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ajr.70162","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:09:39Z","timestamp":1773011379000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Creating a Feasible, Safe and Sustainable Penicillin Oral Challenge Program in a Rural Health Service"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8988-2203","authenticated-orcid":false,"given":"Jaclyn","family":"Bishop","sequence":"first","affiliation":[{"name":"East Grampians Health Service Ararat Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Miller","sequence":"additional","affiliation":[{"name":"East Grampians Health Service Ararat Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"McAdie","sequence":"additional","affiliation":[{"name":"East Grampians Health Service Ararat Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leeanne","family":"Atkinson","sequence":"additional","affiliation":[{"name":"East Grampians Health Service Ararat Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"issue":"10","key":"e_1_2_11_2_1","first-page":"3133","article-title":"The Burden of Self\u2010Reported Antibiotic Allergies in Health Care and How to Address It: A Systematic Review of the Evidence. The Journal of Allergy and Clinical Immunology","volume":"11","author":"Arnold A.","year":"2023","journal-title":"In Practice"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32218-9"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2020.05.042"},{"issue":"3","key":"e_1_2_11_5_1","first-page":"365","article-title":"Improving the Effectiveness of Penicillin Allergy De\u2010Labeling. The Journal of Allergy and Clinical Immunology","volume":"3","author":"Bourke J.","year":"2015","journal-title":"In Practice"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.19283"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14978"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky575"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2024.01.015"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2021.42.200128"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa653"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2023.2296068"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2018.10.009"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2018.09.014"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.2986"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.0403"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.07.048"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlaa123"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajr.12868"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlae014"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlae020"}],"container-title":["Australian Journal of Rural Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajr.70162","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajr.70162","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajr.70162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T03:45:27Z","timestamp":1782099927000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ajr.70162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,7]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/ajr.70162"],"URL":"https:\/\/doi.org\/10.1111\/ajr.70162","archive":["Portico"],"relation":{},"ISSN":["1038-5282","1440-1584"],"issn-type":[{"value":"1038-5282","type":"print"},{"value":"1440-1584","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,7]]},"assertion":[{"value":"2024-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70162"}}