Efficacy of the PEN-FAST score in a French cohort of patients with reported allergy to penicillins.
Front Allergy
; 5: 1439698, 2024.
Article
em En
| MEDLINE
| ID: mdl-39139756
ABSTRACT
Introduction:
Various clinical decision-making tools for penicillin allergy have been developed to guide delabeling strategies.Objective:
To evaluate the penicillin allergy PEN-FAST decision score in a retrospective cohort of patients, adults and children, with penicillin-reported allergy.Methods:
This monocentric retrospective cohort included patients with penicillin-reported allergy. All patients underwent penicillin allergy testing using skin tests and/or drug challenge. The PEN-FAST score sensitivity, specificity, negative (NPV) and positive (PPV) predictive values, and the area under the receiver operating characteristics curve (AUC) were calculated.Results:
Two hundred and fourteen patients were included (64 children and 150 adults). Allergy was confirmed in 52 cases (24%). A PEN-FAST score <3 points showed a poor discrimination capacity for the whole population (AUC = 0.66; 95% CI 0.58-0.75), while it demonstrated a better discrimination capacity in the adults group (AUC = 0.71; 95% CI 0.63-0.80). The sensitivity to identify penicillin allergy using this cutoff of less than 3 points was 0.67 (95% CI 0.52-0.80); specificity, 0.58 (95% CI 0.48-0.68); PPV, 0.43 (95% CI 0.32-0.55); and NPV, 0.78 (95% CI 0.68-0.87).Conclusions:
Although our data confirm a rather good discrimination value of a PEN-FAST score <3 points, its low negative predictive value (78%) did not advocate for its use as an accurate, simple and cost-effective clinical decision-making tool to effectively reduce the number of penicillin skin tests required before direct oral challenge. Further studies are required to improve the predictive capacity of the PEN-FAST score.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Front Allergy
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
França