Penicillin Allergy Clinical Trial
Official title:
Safety, Validity and Efficiency of a Direct Graded Oral Challenge With Amoxicillin for the Evaluation of Penicillin Allergy in Adults
False diagnosis of penicillin allergy are frequently reported, and have been proven detrimental to patients. Current guidelines for the assessment of drug allergies recommend that penicillin allergy be evaluated first with prick and intradermal skin tests, and then completed with a graded oral challenge, spread over at least two doses. However, it has been shown that these skin tests, in addition to consuming resources and time, are of limited, or even doubtful validity, given the poor predictive values that have been reported in the modern penicillins era. It now seems unreasonable to continue their use without addressing other, more efficient diagnostic stategies. Several groups have now demonstrated the safety, validity, and efficiency of a direct, two-step amoxicillin oral challenge (starting with 10% of the standard therapeutic dose, followed by 90 % of the dose), without prior skin tests, first for any type of reaction in the pediatric population, then for any non-immediate reaction in the adult population. The objective of this study is to demonstrate the safety, efficiency, and validity of direct, two-step graded oral challenge with amoxicillin for the evaluation of any reported penicillin allergy in the adult population, excluding high-risk patients (documented anaphylaxis to a penicillin in the last 5 years). Skin tests will first be performed according to the protocol currently in use at the CHUL, then consented patients will proceed with the graded oral challenge still according to the protocol currently in use at the CHUL, but regardless of the skin tests results. The results of the two tests will be compared to determine the safety, efficiency and validity of proceeding directly to the graded oral challenge.
n/a
Status | Clinical Trial | Phase | |
---|---|---|---|
Terminated |
NCT05563610 -
Oral Penicillin Challenge and Allergy De-labeling in Children
|
Phase 4 | |
Completed |
NCT05020327 -
Inpatient Penicillin Allergy Delabeling Study
|
Phase 4 | |
Completed |
NCT04441021 -
Feasibility Assessment of Risk Stratification and Oral Challenge in Hospitalized Children at Low Risk for Antibiotic Allergy
|
||
Not yet recruiting |
NCT05956080 -
Penicillin Allergy Delabeling Among Surgical Patients
|
N/A | |
Completed |
NCT03702270 -
The Effect of Providing Stratification of Low Risk Penicillin Allergies on Penicillin Allergy Label Removal
|
N/A | |
Recruiting |
NCT05464615 -
Geisinger Antibiotic Allergy Pilot Program: Assess and Address
|
Early Phase 1 | |
Completed |
NCT03702283 -
Effect of Providing Stratification of Low Risk Penicillin Allergies on Penicillin Allergy Label Removal in ICU Setting
|
N/A | |
Not yet recruiting |
NCT03499457 -
Penicillin Allergy in Shfayim Clinic
|
N/A | |
Completed |
NCT01667055 -
The Diagnosis of Beta-lactam Hypersensitivity in Thailand
|
||
Withdrawn |
NCT00589251 -
Equivalency of Penicilloate Skin Test Reactivity Prepared by a Modified Alkaline Hydrolysis Technique
|
N/A | |
Completed |
NCT04620746 -
Penicillin Allergy Testing in STD Clinics
|
Phase 4 | |
Completed |
NCT05090527 -
Penicillin Allergy Delabeling Project
|
N/A | |
Completed |
NCT03033394 -
Beta-lactam Pharmacokinetics in Secondary Care
|
||
Completed |
NCT02036840 -
Perioperative Antibiotic Choices for Surgical Prophylaxis in Penicillin-allergic Pediatric Patients
|
N/A | |
Terminated |
NCT00363688 -
Treating Patients With a History of Non-Life Threatening Allergic Reaction to Penicillin With Penicillin
|
Phase 4 | |
Completed |
NCT03158831 -
Drug Challenges Without Prior Skin Testing
|
Phase 1 | |
Recruiting |
NCT06303128 -
Penicillin Allergy Delabeling After a One-Dose Versus Two-Dose Graded Direct Oral Challenge
|
Phase 3 | |
Completed |
NCT03942731 -
Penicillin Allergy Testing and Resensitization Rate
|
||
Completed |
NCT05010304 -
Penicillin De-labeling in the Pediatric Primary Care Setting
|
Phase 4 | |
Completed |
NCT03404804 -
Oral Challenge in the Pediatric ED
|
Phase 4 |