Evaluation of Direct Oral Challenge Clinic to Assess Penicillin Allergies in a Rural Ontario Setting-Pilot Project

Jan 20, 2023

Penicillin Allergy Delabeling in a Rural Ontario Setting 

Study Physicians:

Malcolm Wilson, MD, FRCPC - General Internist (PI)

Jennifer Macmillan, MD, MSc, FRCSC - General Surgeon

Dave McLinden, MD, CFPC

David Johnstone, MD, FRCPC 

Karen Binkley, MD, FRCPC - Allergy and Immunology Specialist

 

What is it?

The study will collect information and feedback from participants who attend the Direct Oral Challenge clinic, to investigate if the clinic is practical to operate and can impact patient care by addressing mislabeled penicillin allergies. 

       
What will I be doing?

MAHC is developing a method for penicillin allergy testing in an outpatient clinic setting. If you are eligible to attend the clinic, our research team would like your feedback on the experience, whether you complete the Direct Oral Challenge or not. You will be asked to complete a short questionnaire that provides feedback about the clinic on the day you attend. You will also be contacted to complete a short follow-up survey 6 and 12 months after you enter the study. The follow-up survey will ask if you have been prescribed penicillin or related antibiotics like amoxicillin in the time since attending the clinic. You will be asked if you give permission for your allergy history and outcome of attending the DOC to be shared with your healthcare team. Your participation includes only feedback and surveys about your experience.


How do I register?

Contact 705-789-2311 ext. 2705 or research@mahc.ca


Penicillin Allergy Delabeling in a Rural Ontario Setting - FAQs

 

What is penicillin?

Penicillin remains a very useful antibiotic and can be the best antibiotic to treat some common infections like pneumonia and cellulitis (skin infection), as well as some severe infections like necrotizing fasciitis (“flesh eating disease”). 

 

What does it mean when someone has a penicillin allergy?

If you are labelled as having a penicillin allergy, your doctor may have to select a less effective antibiotic to treat your condition, which could result in slower recovery and more side effects

 

What is the purpose of this study?

In this study, we are testing a method to safely evaluate penicillin allergies, remove the penicillin allergy label from medical records, and promote confidence that penicillin, and related antibiotics like amoxicillin, can be taken safely in the future if necessary.

 

How could participating in this study help me?

As an eligible participant, if testing determines that you are not allergic, your medical record at the hospital and with your primary care provider will be updated. In the future, you would be eligible for treatment with penicillin and related antibiotics.

 

I don’t know if I’m allergic…how do I know if I should participate?

Many people report that they have an allergy to penicillin, but often they are uncertain what reaction they had or when it occurred. Participation in this study is voluntary for low-risk* adults, and available to those who think they have an allergy to penicillin or amoxicillin, and have not had formal allergy testing to confirm this. This study is for those who want to know if they can safely receive penicillin without fear of a severe reaction. (*Note: Participants will be screened to determine low-risk eligibility.)

 

What does participation involve?

  1. You will have an initial telephone interview to determine if your reported penicillin allergy can be safely tested in an outpatient clinic setting.
  2. If eligible, you will be offered to book an appointment to receive two doses of amoxicillin (very similar to penicillin), one hour apart, while being monitored closely in the hospital setting, where any allergic reaction can be treated promptly. This will require approximately 2 hours of your time, however you may use your phone, read, or bring another quiet activity to pass the time. 
  3. You will receive a follow up phone call at 1 week and 1 month after the exposure to assess for any delayed reaction. 
  4. We will seek your feedback on the overall experience at 6 and 12 months, to learn if it is feasible to offer this form of allergy testing and delabeling in our community.

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