Drug Allergy Delabeling Programs: Recent Strategies and Targeted Populations

Karen M. Anstey, Lulu Tsao, Iris M. Otani

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Drug allergy delabeling programs have become an essential element of antibiotic stewardship. Development of delabeling programs involves careful selection of target patient population, thoughtful design of delabeling approach, stakeholder engagement, assembly of key team members, implementation, and evaluation of clinical and safety outcomes. Recent programs have targeted patients thought to be most likely to benefit from removal of inaccurate antibiotic allergy labels, those with β-lactam antibiotic allergies and high-risk populations likely to need β-lactam antibiotics as first-line treatment. This review provides an overview of current risk stratification methods and β-lactam cross-reactivity data and summarizes how different inpatient and outpatient delabeling programs have used these concepts in delabeling algorithms. β-Lactam delabeling programs for inpatients, pediatric patients, and programs utilizing telehealth have been implemented with good outcomes. This review also focuses on delabeling programs for high-risk populations likely to benefit from first-line β-lactam antibiotics. These populations include perioperative, prenatal, and immunocompromised patients. Delabeling programs have been successful in the inpatient and outpatient settings at enabling appropriate antibiotic use. This article reviews delabeling strategies utilized by these programs with a focus on highlighting elements key to their success and future areas for innovation.

Original languageEnglish (US)
Pages (from-to)484-504
Number of pages21
JournalClinical Reviews in Allergy and Immunology
Volume62
Issue number3
DOIs
StatePublished - Jun 2022

Keywords

  • Antibiotic allergy
  • Antibiotic stewardship
  • Beta-lactam allergy
  • Cephalosporin allergy
  • Delabeling
  • Drug allergy
  • Penicillin allergy

ASJC Scopus subject areas

  • Immunology and Allergy

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