{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:45:05Z","timestamp":1787013905569,"version":"build-2736575974"},"reference-count":58,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Sex and gender may influence penicillin allergy label (PAL) prevalence and outcomes. This review evaluates the effectiveness and safety of direct delabelling (DD) and oral challenge (OC) for low\u2010risk patients and examines sex and gender differences in reporting and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched PubMed, Database of Abstracts of Reviews and Effects,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      , Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts, medRxiv, Ovid MEDLINE, and Ovid EMBASE until February 2024 for studies including DD or OC compared to no intervention, skin testing or other methods. Two reviewers assessed quality. Meta\u2010analyses were conducted, and subgroup analyses were carried out if\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009&gt;\u2009\u2009\u200975%. Descriptive data was analysed using NVivo 14 and reported narratively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 1046 screened studies, 28 met inclusion criteria (two RCTs, 26 quasi\u2010experimental studies). Sex at baseline was reported in 86% of studies, with 61% females: 18% disaggregated outcomes by sex with a female mean delabelling rate of 66%. Gender variables were not reported. OC was not found to be more or less as effective comparaed to skin testing in RCTs (risk ratio [RR] 1.04; 95% confidence interval [CI] 0.95, 1.13,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200974%). DD interventions had a 27% delabelling rate (95% CI 10%, 50%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200996%), with nursing staff achieving 29% (95% CI 15%, 47%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200963%) and allergists\/immunologists 6% (95% CI 0.00, 0.00,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200920%). Quasi\u2010experimental studies reported 90% delabelling for OC, with 59% by allergists\/immunologists and 90% by pharmacists. Adverse events averaged 4% and were non\u2010severe.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DD and OC are effective for delabelling low\u2010risk penicillin allergies. Comprehensive data is lacking on sex and gender differences, indicating a need for further research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bcp.16366","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T23:44:28Z","timestamp":1734651868000},"page":"684-697","source":"Crossref","is-referenced-by-count":5,"title":["A systematic review and meta\u2010analysis of interventions to delabel low\u2010risk penicillin allergies with consideration for sex and gender"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6385-9718","authenticated-orcid":false,"given":"Mira","family":"Maximos","sequence":"first","affiliation":[{"name":"School of Pharmacy University of Waterloo  Kitchener ON Canada"},{"name":"Women's College Hospital  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Pelletier","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Waterloo  Kitchener ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Elsayed","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Waterloo  Kitchener ON Canada"},{"name":"Schulich School of Medicine and Dentistry  London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen J.","family":"Maxwell","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Waterloo  Kitchener ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherilyn K. D.","family":"Houle","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Waterloo  Kitchener ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brie","family":"McConnell","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Waterloo  Kitchener ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6891-8721","authenticated-orcid":false,"given":"John\u2010Michael","family":"Gamble","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Waterloo  Kitchener ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/clind\/24.4.643"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1543\u20105946(10)80002\u20109"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/380449"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01967062"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13223\u2010020\u201000494\u20102"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2015.05.011"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.09.025"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.04.058"},{"key":"e_1_2_9_10_1","unstructured":"StoneC The effect of providing stratification of low risk penicillin allergies on penicillin allergy label removal.Clinicaltrials.gov[Internet].2018; Available from:https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03702270"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph15030298"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081\u20101206(10)60621\u20107"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2022.43.210002"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.12.998"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21041535"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0000000000000568"},{"key":"e_1_2_9_17_1","unstructured":"HigginsJPT TJChandlerJ CumpstonM LiT PageMJ WelchVA eds.Cochrane Handbook for Systematic Reviews of InterventionsVersion 6.2021.www.training.cochrane.org\/handbook"},{"key":"e_1_2_9_18_1","unstructured":"Centre for Reviews and Dissemination.CRD's Guidance for Undertaking Reviews in HealthCare. 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