Drug allergy: diagnosis and management

Research recommendation(s) from an individual piece of guidance

Guidance:

Drug allergy: diagnosis and management

Date issued:

03 September 2014

Research recommendations coming out of this guidance

• Designing systems for documenting drug allergy:- Which documentation strategies would be most clinically and cost effective to minimise the number of people who are re-exposed to drugs to which they have a suspected or confirmed allergy, looking in particular at:
  - electronic health records that include features specifically designed to record and alert
  clinicians to drug allergy information, compared with systems without such features and
  - different formats for patient-held, structured drug allergy documentation?
• Communicating information about drug allergy:- In people with suspected or confirmed drug allergies, are patient-focused information strategies more effective than standard NHS practice in increasing people's likelihood of disclosing their drug allergy (or their suspected drug allergy) and therefore reducing the risk of being re-exposed to the affected drug?
• Using selective cyclooxygenase 2 inhibitors in people with previous severe allergic reactions to non-selective non-steroidal anti-inflammatory drugs:- Should all patients who have experienced a severe allergic reaction to a non-selective non-steroidal anti-inflammatory drug (NSAID) be assessed by specialist drug allergy services or should they be advised to take a selective cyclooxygenase 2 (COX 2) inhibitor without further investigations if clinically appropriate?
• Oral antibiotic challenge for diagnosing antibiotic allergy in children:- In children who have a suspected allergy to an antibiotic, is it clinically and cost effective to proceed directly (without prior skin or intradermal tests) to a diagnostic oral antibiotic challenge rather than referring them to specialist drug allergy services?