. Author manuscript; available in PMC: 2020 Jul 1.

Published in final edited form as: Ann Allergy Asthma Immunol. 2019 Apr 19;123(1):16–34. doi: 10.1016/j.anai.2019.04.009

Table 2.

Challenge-based beta-lactam allergy pathways in acute care

Study	Location	Setting	Patient Selection	Study Design	Intervention Description	Outcome(s) measured
Krishna (2017)³¹	Birmingham, United Kingdom	Large teaching hospital	Adult patients that are not unconscious and without altered mental status	Development and conceptual framework	Electronic guideline including an e-questionnaire about the allergy history and host factors and answers that interfaces with computerized decision support system (“CDSS,” electronic software that guides the risk stratification into high or low risk). Low risk patients undergo a direct 250 mg amoxicillin challenge	Not applicable
Trubiano (2018)²⁹	Melbourne, Australia	1 referral cancer hospital and 1 academic medical center	Adult patients with penicillin allergy labels including a cohort with cancer	Pre/Post of 46 patients including 10 inpatients with cancer and 19 inpatients without cancer, all with low-risk penicillin allergy	Allergy history-based guidance for oral penicillin re-challenge program	Alternative ABX use	Restricted ABX 90 days pre/post decreased from 55% to 23%
						BL use	Penicillin use 90 days pre/post was increased from 23% to 77%
						Safety	There were no ADRs

Abbreviations: ABX, antibiotic; BL, beta-lactam; ADR, adverse drug reaction