Outcomes of a penicillin allergy de-labelling implementation intervention in a UK hospital: a prospective, single centre, type 2 hybrid effectiveness-implementation study evaluated using mixed methods

作者：Neil Powell, Daniel Hearsey, Robert West, Mathew Upton, Bridie Kent, Sarah Tonkin-Crine, Jonathan Sandoe · 发表于：Implementation Science Communications · 年份：2026 · DOI：10.1186/s43058-026-01008-8 · 被引用次数：1 · 研究领域：Drug-Induced Adverse Reactions、Contact Dermatitis and Allergies、Antibiotic Use and Resistance

BACKGROUND: Non-allergy specialist healthcare workers removing low-risk penicillin allergy (penA) records, enabling patients to receive penicillin antibiotics, is safe but not common practice. We developed a behavioural change implementation intervention to support non-allergist healthcare workers to remove incorrect penA records from adult inpatients (penicillin allergy de-labelling; PADL). This study aimed to evaluate the effectiveness of the implementation intervention strategy and its impact on delabelling and antibiotic prescribing. METHODS: June 2024. This prospective, single centre, type 2 hybrid effectiveness-implementation study was evaluated using mixed methods: process evaluation, qualitative and quantitative study designs. The proportion of patients delabelled was measured. Antibiotics were grouped into the three WHO AWaRe categories with differences in antibiotic use between the de-labelled and non-de-labelled measured. Pearson chi-squared tests, Welch's t-tests or Wilcoxon matched-pairs signed-rank tests were used. RESULTS: December 2024, the mean number of penicillin allergy records removed from the inpatient electronic prescribing system increased from 18.2/month pre-intervention to 42.7/month post intervention. Of 186 patients de-labelled with full data capture, the majority 126 (67.7%) were de-labelled by the antimicrobial pharmacists and the remainder by ward doctors or ward pharmacists across 21 clinical specialties. Antibiotic exposure, when grouped by WH...