Accès ouvert déclaré
2026
article
Direct Oral Challenge for Penicillin Allergy: The International Network of Antibiotic Allergy Nations (iNAAN) Study
Elise Mitri, Luke R Fletcher, Sara Vogrin, Sara Barnes, Neil Powell, Jonny Peter, Philip H Li, Ana Maria Copaescu, Nicholas Turner, Fiona James, Camille Paynter, Richard Sullivan, Maryam Sherkat Masoum, Matthew Rawlins, Geoff Mackay, B. Smith, Patricia Kilfoyle, Daniel Forster, Morgan Rose, Raquel Cowan, Kylie Alcorn, Anna Brischetto, Andrew A. Mahony, Andrew M. Redmond, Arindam Chakravorty, Zaal Meher-Homji, Chino Yuson, Simeon Crawford, GR Weeks, Sasheela Sri La Sri Ponnampalavanar, Constance H. Katelaris, Priscilla Tran, Jennifer O’Hern, Jack Godsell, Trisha N Peel, I. Sandaradura, David New, Candice Holland, Tim Cutfield, Sarah Coghill, Caitlin Hand, Jacob Williams, Jaclyn Bishop, Belinda Lambros, Cascia Day, Courtney Ierano, Jay Roberts, Natasha E. Holmes, Marlena Klaic, SL Fernando, Jason A. Trubiano, for the International Network of Antibiotic Allergy Nations (iNAAN) study group, Kyra Chua, Joseph De Luca, Gemma Reynolds, Evelyn Lorraine Andrews, Daniel G Lapirow, Abby Douglas, Tanya Crichton, Kate Guy, Jessica Jarvis, Tapiwa Rusike, Benjamin Bowen, Martin Keen, Suman Adhikari, Sara Isabel Queirós Nóbrega, Ekua Brenu, Rachael Roberts, Lilian Whelan, Romeo Torres, Chloe Edwards, Laura Bywater, Jamma Li, Thérèse Boyle, Melanie Figtree, Jessica Bui, Christy El-Khoury, Claire M. Italiano, Elizabeth Leahy, Emily Heke, Antje Lutjen, Kevin Nguyen, Marsus Pumar, Mittal Patel, Madonna Khreish, Nazanin Khorshidi, Amanda Nichols, Maria Deetlefs, Marshe Maharaj, Carrie McDougall, Jason Fok, Frank Thien, Stephen Guy, Kylie D’Arcy-Evans, John Dyer, Melinda Jiang, Saima Ahmad, Janice Chiang, Alicia Neels, Callum Maggs, Caroline Bartolo, Nicholas Ah Yui, Karen Lim, Kathryn Wilks, Sarah Kingscote, Lisa Course, Kate Morton, Michelle Donohue, Jack Cross, Samuel Smith, Philip Tibbits, Jenny Park, Gabrielle Louise Langron Chau, Lawrence Ong, Sanjay Swaminathan, S.M. Keady, Lakshana Kalatharan, Raelene Vine, Judy Lamb, Jenny Wan Sai Cheong, D. Brownridge, David C. M. Kong, Michael J. Loftus, Jodi Poole, Leeanne Atkinson, Amrita Ronnachit, Frederick J. Lee, Peter Bradhurst, Alex Stoyanov, Nicholas Urriola, Lisa Horgan, Karen Wells, Kristine Millar, Sophie Briggs, Chloe Bishop, Joseph Doyle, Rachael Leng, Esha Tamrakar, Kelly A. Cairns, Ng Rong Xiang, Anjanna Kukreja, Sheron Goh Sir Loon, Ong Hang Cheng, Bushra Binti Megat Johari, Sazali Basri, Ng Sin Hui, Tan Yee Ann, Ho Ai Wui, Jacky Richards, Daniel Hearsey, Nicola Leigh, Elizabeth Haigh, Marie Thomas, Helen H. Winn, Tamsyn Lewis, Angie Gray, Jane Williams, S. Weeks, Amanda Barone Pritchard, Owen O’Reilly, Nathan Ratnam, Shamika Ratnayake, Hoan Dang, Sarah Risdale, Kim Ta, Alice Young, Jacqueline van der Meulen, Rocky Shi, Jane Wong, Valerie Chiang, Gordon Chu, James Hooi, Moneerah AlGassim, Adhora Mir, Rachael J Wiedmann, Rebekah Wrenn, Natalie Harris, Amy Mackowiak, Karen Watt, Sylvia White, Jacob Griffiths, Katie Jodrell, Michaela Lucas, Benjamin Mulo, Astrid Arellano, Christopher Kleeman, Kate Grogan, Steven Tong, Samantha Chan, Kasha P Singh, Douglas Johnson, Kymble Spriggs, Samuel Thorburn, Catherine Fitzpatrick, Jessie Zhou, Karen Giang, Christina Vytilingam, Amanda Jackson, Natasha Pool, Maureen Turner, Javier Haurat, Wisam Abdelaziz
3Citations signalées, ce qui n’est pas une note de qualité
63Institutions déclarées
12Pays d’affiliation déclarés
Rattachement africain : us, au, gb, Afrique du Sud, hk, ca, in, my, nz, ir, Ouganda, fr.
Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Approximately 10% of hospitalized patients globally report a penicillin allergy, leading to inappropriate antibiotic prescribing and inferior healthcare outcomes. Evidence supporting the effectiveness and widespread implementation of inpatient penicillin direct oral challenge (DOC) is limited. METHODS: A prospective, multicenter, international type 2 hybrid effectiveness-implementation study was conducted in 40 hospitals across 8 countries between November 2022 and May 2025. Adult inpatients with a penicillin allergy underwent assessment using a digital penicillin allergy toolkit (National Antibiotic Allergy Network [NAAN] App). According to site clinical practice, participants received penicillin DOC (effectiveness intervention) or assessment only. Participating sites received bimonthly audit and feedback at least 3 months after site activation (implementation strategy). Observational data were used to emulate a target trial to examine secondary effectiveness outcomes, including antibiotic prescribing at 90 days in DOC versus non-DOC participants. The primary implementation outcome was adoption of the NAAN App within 6 months of site activation. RESULTS: Among 5121 participants assessed, 1573 (30.7%) underwent DOC, of which 1502 (95.5%) were delabeled. Of 71 (4.5%) participants with a positive DOC, 6 (0.4%) had a serious adverse event. Of 1852 inpatients in the target trial analysis, 892 underwent DOC and 960 underwent assessment only. Participants who underwent DOC were more likely to be prescribed penicillin (risk ratio [RR], 13.25 [95% confidence interval {CI}, 7.82-22.46]), and less likely to be prescribed World Health Organization (WHO) "Watch" or "Reserve" antibiotics (RR, 0.73 [95% CI, .60-.89]) at 90 days post evaluation. Within 6 months of site activation, 77 clinicians adopted the NAAN App. CONCLUSIONS: Multidisciplinary adoption of inpatient penicillin DOC was safe and significantly improved penicillin prescribing and reduced use of WHO restricted antibiotics.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Direct Oral Challenge for Penicillin Allergy: The International Network of Antibiotic Allergy Nations (iNAAN) Study
- Date Crossref
- 01/04/2026
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Les institutions déclarées
Une affiliation ne permet pas de déduire la nationalité d’un auteur.
Les sujets associés
Drug-Induced Adverse ReactionsPharmacovigilance and Adverse Drug ReactionsAntibiotic Use and Resistance