Nurse-and-allergist provocation pathway for penicillin allergy delabelling (PANDA)
Provocation After Nurse-Directed Assessment (PANDA) Study
This project will try a nurse-and-allergist team approach to remove incorrect penicillin allergy labels in patients treated at participating hospitals, and compare it to the usual allergist-only pathway.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 440 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | The University of Hong Kong Academic / other |
| Locations | 4 sites (Hong Kong and 3 other locations) |
| Trial ID | NCT07127835 on ClinicalTrials.gov |
What this trial studies
PANDA is an observational comparison of a nurse-allergist collaborative delabelling service versus a traditional allergist-led service for patients with a documented penicillin allergy across three Hong Kong hospitals. Patients are stratified by clinical risk and, where appropriate, undergo nurse-directed history-taking and drug provocation testing with allergist oversight; clinical outcomes, safety events, and quality-of-life measures are recorded. The study collects demographic and clinical data from inpatient and outpatient records and compares resource use and cost-effectiveness between the two care models. Exclusions include patients without a complete medication/allergy history, those with only short-term emergency records, or recent use of steroids or antihistamines that would affect testing.
Who should consider this trial
Good fit: Patients with a documented penicillin allergy who are receiving care at one of the participating Hong Kong hospitals and can provide a complete medication and allergy history.
Not a fit: Patients unable to provide a full allergy or medication history, those with only emergency or short-term records, or those who recently used steroids or antihistamines likely will not benefit from this delabelling approach.
Why it matters
Potential benefit: If successful, the collaborative pathway could safely remove incorrect penicillin allergy labels faster and at lower cost, increasing appropriate antibiotic options for patients.
How similar studies have performed: Previous programs using risk stratification and direct drug provocation for penicillin delabelling, including nurse-led pathways, have shown good safety and high rates of successful delabelling.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Receiving inpatient or outpatient treatment at a participating hospital during the study period; * Possessing a documented penicillin allergy label; * Underwent penicillin allergy evaluation by the nurse-allergist collaborative approach or the traditional allergist-led approach * Demographic and clinical data required for the study available. Exclusion Criteria: * Patients unable to provide a complete medication history or history of penicillin allergy; * Patients with only emergency or short-term treatment records; * Patients who have taken steroids, antihistamines, or similar medications within the last 3 days.
Where this trial is running
Hong Kong and 3 other locations
- Prince of Wales Hospital — Hong Kong, Hong Kong (Recruiting)
- Princess Margaret Hospital — Hong Kong, Hong Kong (Recruiting)
- Queen Elizabeth Hospital — Hong Kong, Hong Kong (Recruiting)
- Queen Mary Hospital — Hong Kong, Hong Kong (Recruiting)
Study contacts
- Study coordinator: Elaine Lee
- Email: le446@hku.hk
- Phone: 852 9440 3349
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.