Improving inpatient paediatric de-labelling of allergies to beta-lactams: a quality improvement study
Objective To evaluate the implementation of an antimicrobial stewardship programme-led inpatient beta-lactam allergy de-labelling programme using a direct oral provocation test (OPT). Design One-year quality improvement study using a before–after design. Setting Free-standing tertiary care paediatric hospital. Patients Patients with a reported beta-lactam allergy admitted to the paediatric medicine inpatient unit. Interventions Following standardised assessment and risk stratification of reported symptoms, patients with a low-risk history were offered an OPT. Beta-lactam allergy labels were removed if a reported history was considered non-allergic or after successful OPT. Main outcome measures Removal of inappropriate beta-lactam allergy labels. Results 80 patients with 85 reported beta-lactam allergies were assessed. Median age was 8.1 years (IQR 4.8–12.9) and 34 (42%) were female. The majority (n=55, 69%) had an underlying medical condition. Amoxicillin was the most reported allergy