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Geisinger Antibiotic Allergy Pilot Program: Assess and Address
Sponsor: Geisinger Clinic
Summary
This is a prospective non-inferiority study to evaluate penicillin allergy history in patients with reported penicillin allergy, who require penicillin or penicillin-derivative antibiotic during inpatient admission using a focused questionnaire. A simplified scoring system will be assigned to patient responses, and the total score will be utilized to identify low-risk patients that have a minimal risk of allergic reactions on exposure to penicillin or its derivative. Patients determined to have low risk based on this questionnaire will be offered a test dose (graded challenge) of amoxicillin in a supervised setting, and if they tolerate it, penicillin allergy label will be removed from patient's chart. We hypothesize that at least 95% of low-risk patients will successfully pass the graded amoxicillin challenge so the penicillin allergy label can be removed from their charts. A proportion as low as 0.85 would be a good clinical outcome and considered non-inferior to the expected proportion of 0.95.
Official title: Geisinger Antibiotic Allergy Pilot Program: Assess and Address (GAAP) Penicillin Allergy De-labeling in Inpatient Setting by Performing Direct Oral Amoxicillin Challenge in Low-risk Patients
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
100
Start Date
2024-03-04
Completion Date
2025-12-31
Last Updated
2025-08-22
Healthy Volunteers
No
Conditions
Interventions
Amoxicillin
We will initially administer 1/5th (56 mg) of the goal dose of amoxicillin (256 mg) by oral route following the procedure outlined below. The total goal dose to be administered is amoxicillin 256 mg (3.2 ml of 400 mg/5 ml). These were numbers that came about for significance in relabeling penicillin allergies in patients in previous studies.
Locations (3)
Geisinger Medical Center
Danville, Pennsylvania, United States
Geisinger Community Medical Center
Scranton, Pennsylvania, United States
Geisinger Wyoming Valley
Wilkes-Barre, Pennsylvania, United States