Penicillin Allergy Delabeling Project

NCT ID: NCT05090527

Last Updated: 2024-02-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

153 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-28

Study Completion Date

2023-05-01

Brief Summary

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A investigational study to establish:

1. A validated cllinical pathway for delabeling declared Penicillin allergiy outside allergologic departments.
2. A survey to examine anesthesiologists attitudes and knowledge about penicillin delabeling.
3. A qualitative focus group study investigating barriers and facilitators in penicillin delabeling among hospital nurses and physichians.

2\. Implement the pathway for delabeling declared penicillin allergy outside allergologic clinics across the Western Norway health region.

Detailed Description

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Patients labeled penicillin allergic is a significant and growing public health problem. 10% of all patients report penicillin allergy. 9 out of 10 however tolerate penicillin on provocation, To be labeled as penicillin allergic has several well documented negative health outcomes for the individual, and on a public health scale.

One of the biggest obstacles in delabeling penicillin allergy is the lack of validated tools i Norwegian, the lack of in vitro tests for severe late /T cell mediated reactions and the accessibility of the gold standard procedure, drug provocation test.

In this study patients having a penicillin allergy label will after giving their written concent be screened used a risk stratification tool. The low risk patient will then directly undergo a single full dose amoxicillin challenge. High risk patients are refered to a allergologic clinic and undergoes full allergologic examination. The investigators seek to document that in low risk patients is a single dose Amoxicillin challenge safe and beneficial outside an allergologic clinic, and to validate the risk stratification tool in Norwegian.

To implement such pathways i qualitative data is needed to facilitate the right efforts and translate the method into every day clinical practice in a sustainable way. Here a anesthesiologist survey and focus group interviews with hospital nurses and physichians is planned.

Finally we will implement the method in an implementation study across the Western Norway Health region

Conditions

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Penicillin Allergy

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Entry criteria: Penicillin allergy noted in patients journal or patient reported.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

None, open provocation test with amoxicillin for eligible patients after risk stratification with a questionnaire.

Study Groups

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Directly delabeled trough risk stratification tool

Patients who are stratified as " no penicillin allergy" undergo a one dose full dose provocation test with 500 mg amoxicillin.

Group Type ACTIVE_COMPARATOR

Risk stratification

Intervention Type DIAGNOSTIC_TEST

advanced penicillin challenge after risk stratification

Low risk patients

Patients stratified as low risk on penicillin provocation undergo a one dose full dose provocation test with 500mg amoxicillin

Group Type ACTIVE_COMPARATOR

Risk stratification

Intervention Type DIAGNOSTIC_TEST

advanced penicillin challenge after risk stratification

High risk

Patient stratified as high risk undergo a full allergologic work up, and only some of these will undergo a provocation test.

Group Type ACTIVE_COMPARATOR

Risk stratification

Intervention Type DIAGNOSTIC_TEST

advanced penicillin challenge after risk stratification

Interventions

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Risk stratification

advanced penicillin challenge after risk stratification

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Penicillin allergy in the patient journal oder patient reported

Exclusion Criteria

* Not able to give concent. Under 16 years of age.
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Helse Fonna

OTHER

Sponsor Role collaborator

Helse Forde

OTHER

Sponsor Role collaborator

Haraldsplass Deaconess Hospital

OTHER

Sponsor Role collaborator

Helse Stavanger HF

OTHER_GOV

Sponsor Role collaborator

Haukeland University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Torgeir Storaas, phd

Role: STUDY_CHAIR

RAAO vest

Locations

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Haukeland University Hospital

Bergen, , Norway

Site Status

Helse Førde

Førde, , Norway

Site Status

Countries

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Norway

References

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Alnaes MB, Oppegaard O, Kittang BR, Lygre SHL, Langeland AB, Skodvin B, Bjanes T, Storaas T. A new pathway for penicillin delabeling in Norway. World Allergy Organ J. 2023 Oct 16;16(11):100829. doi: 10.1016/j.waojou.2023.100829. eCollection 2023 Nov.

Reference Type RESULT
PMID: 37868111 (View on PubMed)

Other Identifiers

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199210

Identifier Type: -

Identifier Source: org_study_id

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