Antibiotic allergy de-labeling in the intensive care unit: The prospective ADE-ICU study
Authors' conclusion
This study shows the feasibility of ICU led antibiotic allergy assessment and testing, highlighting a potential model for implementation in settings lacking immunology/allergy services.
Study context
- Population
- Critically ill intensive care unit (ICU) patients with an antibiotic allergy label62 assessed
- Participants
- 71 patients
- Outcome
- Antibiotic allergy de-labeling in patients with a non-immune, low or intermediate risk allergy
Methodological detailsICU-led, independent of immunology/allergy services, Trained ICU staff risk assessed patients; non-immune reactions directly de-labeled; low risk: direct drug provocation testing; intermediate risk: skin testing then drug provocation testing; high risk confirmed without testing
- ICU-led, independent of immunology/allergy services
- Trained ICU staff risk assessed patients; non-immune reactions directly de-labeled; low risk: direct drug provocation testing; intermediate risk: skin testing then drug provocation testing; high risk confirmed without testing
Main finding
As reported in the abstract
Antibiotic allergy de-labeling (non-immune, low or intermediate risk allergy)
De-labeled
48 of 51 patients
94 %
Observational data: associations, not effects.
Further findings
High risk allergies confirmed
- Confirmed without testing
- 11 patients (18 %)
Antibiotic use
- Increased penicillin use and decreased broad-spectrum antibiotic use
Safety
- No adverse events from testing
Original publication
Antibiotic allergy de-labeling in the intensive care unit: The prospective ADE-ICU study. J Crit Care. Published 27 November 2024. doi:10.
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