Most Proposed Topic :
Healthcare Advances, Research and Innovations (new projects / technology)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors: (including presenting author): :
Ho PK, Chan WH, Chen LF, Chan TH, Chow WY, Lo SW, Yau YS, Chan KY
Affiliation: :
Department of Paediatrics, Queen Elizabeth Hospital
Introduction: :
Drug allergy delabeling program had been proven to promote appropriate use of drugs, reduce antibiotic resistance and failure, reduce adverse drug reactions related to use of alternative or broader spectrum antibiotic, reduce hospital stay duration and reduce health care cost.
Objectives: :
To perform drug allergy tests for paediatric patients labelled with suspected drug allergies and delabel patients who do not have genuine drug allergy.
Methodology: :
Paediatric patients found to have suspected drug allergy during clinical encounter in Department of Paediatrics of Queen Elizabeth Hospital were referred to and assessed by paediatric allergist then underwent appropriate drug allergy test in paediatric day ward.
Result & Outcome: :
From March 2021 to December 2023, 30 paediatric patients with suspected drug allergies underwent drug allergy tests. Of note, the service was largely suspended in 2022 due to pandemic. The mean age was 10 years old (IQR 6 to 14). 63.3% were male. 73.3% patients’ suspected allergic drugs were antibiotics, among which augmentin (40%) and zinnat (13.3%) were most common. It was followed by panadol (13.3%) and NSAID (6.7%). For suspected drug allergic reaction semiology, 80% patients had a history of rash, while 20% had angioedema. The median time from reaction to test was 6 months (IQR 3 to 60). 80% of patients underwent graded drug provocation tests. Only 20% of patient required skin prick and intradermal drug tests. 90% of patient had their drug allergy successfully delabeled. Only 10% of patients had genuine drug allergy. No patient had severe allergic reaction during tests. Conclusion: Drug allergy delabeling program via appropriate drug allergy test is effective in removing non-genuine drug allergy label in 90% of paediatric patients labelled to have suspected drug allergy. It is cost effective, safe and can be performed in day centre setting.
