Penicillin Allergy De-Labelling in Elective Surgical patients (PADLES)
Research type
Research Study
Full title
Penicillin Allergy De-Labelling in Elective Surgical Patients - A Study to Determine the Safety, Efficacy and Feasibility of Abbreviated Allergy Testing.
IRAS ID
222993
Contact name
Louise Savic
Contact email
Sponsor organisation
Leeds Teaching Hospitals NHS Trust
Duration of Study in the UK
1 years, 6 months, 0 days
Research summary
Penicillin antibiotics are safe and inexpensive, and kill selected bacteria rather than big range. Unfortunately, around 10% of the population are labelled as ‘penicillin allergic’, often based on side effects such as rash and sickness, rather than true allergy. Up to 90-95% of people with the label are not actually allergic to the drug, when tested.
The label itself can be linked to harm. It leads to the use of alternative antibiotics, which tend to more toxic, and less specific about which bacteria they kill; this increases the risk of getting 'super-bugs', compared to patients without the label. People with the label also tend to have to stay in hospital longer, and come back into hospital more often. These are problems are bad for individuals, and also for society.
In order to check whether someone is allergic to penicillin or not, they generally have skin tests first, where very small injections of penicillin are given into the top layer of skin. However, in reactions from a long time ago, these tests are very unreliable, and if the reaction sounds like a side effect rather than true allergy, patients are then given a dose of penicillin by mouth to see if they can take it without any problems. In some centres, patients who had rashes in childhood, nausea, and other side effects, are given penicillin by mouth without having the skin tests first. This streamlines the process, making it cheap, quicker, and easier for patients. The pathway is recommended in Australia and New Zealand, but is not yet standard in the UK.
We aim to show that this pathway offers a safe, quick, and effective way to remove the penicillin allergy label in large numbers of patients undergoing routine surgery.
REC name
Yorkshire & The Humber - Leeds East Research Ethics Committee
REC reference
17/YH/0096
Date of REC Opinion
28 Apr 2017
REC opinion
Further Information Favourable Opinion