Authors call for aggressively delabeling these patients to avoid treatment failure
By Lori Solomon HealthDay Reporter
FRIDAY, Oct. 25, 2024 (HealthDay News) — Delabeling patients with syphilis who believe they are allergic to penicillin is safe, according to a study presented at the annual meeting of the American College of Allergy, Asthma & Immunology, held from Oct. 24 to 28 in Boston.
Aiwei Yan, M.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues retrospectively reviewed penicillin allergy-labeled patients with confirmed syphilis referred to a drug allergy clinic for assessment and delabeling from 2014 to 2024.
The researchers identified 12 patients, 83.3 percent were male, and the median age was 39 years. Nine patients were treated with doxycycline prior to evaluation, some multiple times (five successful and seven failed treatments in total). There was one ceftriaxone-treated patient who failed treatment. In the intensive care unit, three patients were desensitized to penicillin. There was a pregnancy complicated by congenital syphilis in one female patient treated with penicillin desensitization. All patients were ultimately delabeled of their penicillin allergy, with nine of 12 having documented subsequent penicillin treatment; three participants were incomplete or lost to follow up. Of the nine individuals who received penicillin, five had clearance, three failed clearance (two due to reinfection, one for unknown reasons), and one had unknown clearance outcome.
“We have shown that most patients labeled as penicillin allergic that are low risk should be aggressively delabeled to avoid treatment failure, increased health care utilization, and negative public health consequences,” the authors write.
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