The Feasibility and Applicability of Pediatric Inpatient Beta Lactam De-Labeling: From Bedside Challenge to Long-Term Follow Up.
Direct oral challenge safely de-labeled most children with beta-lactam allergy
The Feasibility and Applicability of Pediatric Inpatient Beta Lactam De-Labeling: From Bedside Challenge to Long-Term Follow Up.
Beta-lactam allergy (beta-lactam allergy) labels are common in pediatric patients but are often inaccurate, leading to unnecessary use of second-line antibiotics.
This study aimed to evaluate the feasibility and barriers of an inpatient pediatric beta-lactam allergy de-labeling program, from bedside oral challenge tests to long-term follow-up and integration into electronic medical records (electronic medical records).
We conducted a prospective interventional study in the pediatric ward between 2019 and 2024.
All patients had a history of a mild reaction, 100% presented with a benign rash.
At follow-up (median 37 months), 35.7% of caregivers reported de-labeling, while electronic medical records documented higher rates (Health Maintenance Organization: 80%; hospital: 70%).
Despite successful oral challenge tests, discrepancies between caregiver understanding, physician attitudes, and electronic medical records documentation persisted.
While direct oral challenge tests are proved to be effective in de-labeling beta-lactam allergy, significant challenges persist in implementing inpatient de-labeling and ensuring their long-term success.
These include low recruitment rates, pediatricians' misconceptions and incomplete integration into electronic medical records.
Addressing these barriers requires targeted education, improved communication, and streamlined processes to improve de-labeling outcomes and support antibiotic stewardship.