Neil Powell
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View article: Assessing a penicillin allergy de-labelling implementation intervention in a UK hospital: a process evaluation reporting healthcare workers’ experiences
Assessing a penicillin allergy de-labelling implementation intervention in a UK hospital: a process evaluation reporting healthcare workers’ experiences Open
Background and objectives Penicillin allergy (penA) records prevent first-line penicillin antibiotic use, but more than 90% are incorrect after formal testing and can be removed (‘de-labelled’). We developed an implementation intervention …
View article: Procalcitonin to guide antibiotic use during the first wave of COVID-19 in English and Welsh hospitals: integration and triangulation of findings from quantitative and qualitative sources
Procalcitonin to guide antibiotic use during the first wave of COVID-19 in English and Welsh hospitals: integration and triangulation of findings from quantitative and qualitative sources Open
Aim To integrate the quantitative and qualitative data collected as part of the PEACH (Procalcitonin: Evaluation of Antibiotic use in COVID-19 Hospitalised patients) study, which evaluated whether procalcitonin (PCT) testing should be used…
View article: Penicillin allergy de-labelling implementation intervention in a UK hospital: a process evaluation, the patient experience
Penicillin allergy de-labelling implementation intervention in a UK hospital: a process evaluation, the patient experience Open
Background Penicillin allergy (penA) records are common, but true penA is rare. PenA records are associated with broad spectrum antibiotic prescribing and negative patient outcomes. We developed a behavioural intervention package to suppor…
View article: Description of the combined evidence-based, theory-based and person-based approaches used to develop a behavioural intervention package to support non-allergist healthcare workers to remove incorrect penicillin allergy records from medical and surgical adult inpatients in a UK hospital
Description of the combined evidence-based, theory-based and person-based approaches used to develop a behavioural intervention package to support non-allergist healthcare workers to remove incorrect penicillin allergy records from medical and surgical adult inpatients in a UK hospital Open
Objectives To develop a behavioural intervention package to support non-allergist healthcare workers (HCWs) to remove incorrect penA records from medical and surgical adult inpatients. This paper describes the development of the penicillin…
View article: P29 A nurse-run, pharmacist-led outpatient penicillin allergy de-label clinic in Cornwall
P29 A nurse-run, pharmacist-led outpatient penicillin allergy de-label clinic in Cornwall Open
Background Penicillin allergy (penA) records are common, but 95% of patients with penA records are able to take penicillin antibiotics after formal allergy testing.1 PenA records are associated with broad spectrum antibiotic prescribing an…
View article: Penicillin allergy assessment pathway versus usual clinical care for primary care patients with a penicillin allergy record in the UK (ALABAMA): an open-label, multicentre, randomised controlled trial
Penicillin allergy assessment pathway versus usual clinical care for primary care patients with a penicillin allergy record in the UK (ALABAMA): an open-label, multicentre, randomised controlled trial Open
View article: O03 Antimicrobial pharmacist led penicillin allergy de-labelling (PADL) is safe and effective at removing low risk penA records
O03 Antimicrobial pharmacist led penicillin allergy de-labelling (PADL) is safe and effective at removing low risk penA records Open
Objectives To implement a penicillin allergy de-labelling (PADL) intervention in adult medical and surgical specialties, delivered by both the wider clinical teams and antimicrobial stewardship (AMS) pharmacists. Methods The core (PADL) im…
View article: P23 Procalcitonin testing in acute infection to guide antibiotic course lengths in the ICU as a tool for antibiotic stewardship
P23 Procalcitonin testing in acute infection to guide antibiotic course lengths in the ICU as a tool for antibiotic stewardship Open
Background Procalcitonin (PCT) was introduced into the ICU during the COVID-19 pandemic. PCT enables optimization of antibiotic course lengths for ICU patients, positively impacting antimicrobial stewardship. Objectives To evaluate local a…
View article: Direct oral penicillin challenge in secondary care with low-risk patients: the SPACE mixed-methods study with cost-effectiveness analysis
Direct oral penicillin challenge in secondary care with low-risk patients: the SPACE mixed-methods study with cost-effectiveness analysis Open
Some text in this abstract has been adapted from Krishna MT, Bhogal R, Ng BY, Kildonaviciute K, Jani YH, Williams I, et al . A multicentre observational study to investigate feasibility of a direct oral penicillin challenge in de-labelling…
View article: Hospital Clinicians’ Knowledge of and Opportunity and Motivation for Prescribing Short Antibiotic Courses for Common Infections
Hospital Clinicians’ Knowledge of and Opportunity and Motivation for Prescribing Short Antibiotic Courses for Common Infections Open
Short-course antibiotic therapies for common infections treated in hospital are supported by national guidelines. Hospital clinicians’ knowledge of the course length recommendations for the management of common infections has not been full…
View article: Procalcitonin evaluation of antibiotic use in COVID-19 hospitalised patients: The PEACH mixed methods study
Procalcitonin evaluation of antibiotic use in COVID-19 hospitalised patients: The PEACH mixed methods study Open
Background Early in the COVID-19 pandemic, there was concern about potentially unnecessary antibiotic prescribing in the National Health Service. Procalcitonin testing was being used in some hospitals to guide antibiotic use. This study ai…
View article: Characteristics, risk factors and clinical impact of penicillin and other antibiotic allergies in adults in the UK General Practice: A population-based cohort study
Characteristics, risk factors and clinical impact of penicillin and other antibiotic allergies in adults in the UK General Practice: A population-based cohort study Open
Penicillin and other antibiotic allergy labels are common and lead to radical change in the antibiotic prescribing practices and are associated with resistant and healthcare associated infections.
View article: A retrospective propensity-score-matched cohort study of the impact of procalcitonin testing on antibiotic use in hospitalized patients during the first wave of COVID-19
A retrospective propensity-score-matched cohort study of the impact of procalcitonin testing on antibiotic use in hospitalized patients during the first wave of COVID-19 Open
Background Procalcitonin (PCT) is a blood marker used to help diagnose bacterial infections and guide antibiotic treatment. PCT testing was widely used/adopted during the COVID-19 pandemic in the UK. Objectives Primary: to measure the diff…
View article: Factors influencing implementation and adoption of direct oral penicillin challenge for allergy delabelling: a qualitative evaluation
Factors influencing implementation and adoption of direct oral penicillin challenge for allergy delabelling: a qualitative evaluation Open
Background Over 95% of penicillin allergy labels are inaccurate and may be addressed in low-risk patients using direct oral penicillin challenge (DPC). This study explored the behaviour, attitudes and acceptability of patients, healthcare …
View article: P29 Understanding penicillin allergy assessment and delabelling massive open online community
P29 Understanding penicillin allergy assessment and delabelling massive open online community Open
Background PenA records are associated with antibiotic prescribing that is potentially less effective and more harmful. The paucity of allergy specialists worldwide has prompted non-allergist delivered penicillin allergy delabelling (PADL)…
View article: P35 Impact of IV to oral antibiotic switch optimization on nurse time and plastic waste at the Royal Cornwall Hospital Trust
P35 Impact of IV to oral antibiotic switch optimization on nurse time and plastic waste at the Royal Cornwall Hospital Trust Open
Background IV to oral switch (IVOS) is an important antimicrobial stewardship intervention with benefits that include a lower risk of bloodstream and catheter-related infections, reduced equipment costs, lower carbon footprint and reduced …
View article: P34 Hospital clinician knowledge, opportunity and motivation to prescribe short course antibiotic therapy for common infections
P34 Hospital clinician knowledge, opportunity and motivation to prescribe short course antibiotic therapy for common infections Open
Background Antibiotic use drives antimicrobial resistance (AMR), with longer durations increasing the risk of AMR and patient harm through side effects.1,2 Objectives We aimed to assess clinicians’ knowledge of the course length recommenda…
View article: Narrative review of recent developments and the future of penicillin allergy de-labelling by non-allergists
Narrative review of recent developments and the future of penicillin allergy de-labelling by non-allergists Open
This article outlines recent developments in non-allergist delivered penicillin allergy de-labelling (PADL), discusses remaining controversies and uncertainties and explores the future for non-allergist delivered PADL. Recent developments …
View article: The appropriateness of penicillin allergy de-labelling by non-allergist clinical ward teams
The appropriateness of penicillin allergy de-labelling by non-allergist clinical ward teams Open
Using the allergy risk tool, most patients with PenA records were exposed to penicillin appropriately. However, patients meeting high-risk criteria were also exposed to penicillin when the tool excluded them. PenA assessment needs to be ca…
View article: The cost-effectiveness of procalcitonin for guiding antibiotic prescribing in individuals hospitalized with COVID-19: part of the PEACH study
The cost-effectiveness of procalcitonin for guiding antibiotic prescribing in individuals hospitalized with COVID-19: part of the PEACH study Open
Background Many hospitals introduced procalcitonin (PCT) testing to help diagnose bacterial coinfection in individuals with COVID-19, and guide antibiotic decision-making during the COVID-19 pandemic in the UK. Objectives Evaluating cost-e…
View article: Eliciting the barriers and enablers towards anaesthetists giving penicillin-based antibiotic prophylaxis to low-risk patients who have had their penicillin allergy label removed as part of a preoperative delabelling process
Eliciting the barriers and enablers towards anaesthetists giving penicillin-based antibiotic prophylaxis to low-risk patients who have had their penicillin allergy label removed as part of a preoperative delabelling process Open
Background Some penicillin allergy labels can be removed by non-allergy specialists by direct oral challenge, but there is reluctance amongst anaesthetists to give penicillin to these patients. We aimed to assess anaesthetist beliefs about…
View article: A multicentre observational study to investigate feasibility of a direct oral penicillin challenge in de-labelling ‘low risk’ patients with penicillin allergy by non-allergy healthcare professionals (SPACE study): Implications for healthcare systems
A multicentre observational study to investigate feasibility of a direct oral penicillin challenge in de-labelling ‘low risk’ patients with penicillin allergy by non-allergy healthcare professionals (SPACE study): Implications for healthcare systems Open
DPCs can be delivered by non-allergy HCPs. A high proportion of patients with PALs did not progress in the study pathway. Strategies to deliver DPC at optimal points of the care pathway are needed to enhance uptake. Elective settings offer…
View article: P02 Evaluating antibiotic prescribing in pancreatitis: a single-centre retrospective case series
P02 Evaluating antibiotic prescribing in pancreatitis: a single-centre retrospective case series Open
Background Procalcitonin (PCT) has been shown to safely reduce antibiotic use in respiratory tract infections but there is little evidence for other potentially infected body systems. A recent randomized controlled trial (RCT) demonstrated…
View article: Non-allergist healthcare workers views on delivering a penicillin allergy de-labelling inpatient pathway: identifying the barriers and enablers
Non-allergist healthcare workers views on delivering a penicillin allergy de-labelling inpatient pathway: identifying the barriers and enablers Open
Background Non-allergist delivered PADL is supported by UK and World Health Organization guidelines but is not yet routine in UK hospitals. Understanding the views of healthcare workers (HCWs) on managing patients with penA records and exp…
View article: Experiences of an inpatient penicillin allergy de-labelling pathway: capturing the patient voice
Experiences of an inpatient penicillin allergy de-labelling pathway: capturing the patient voice Open
Background Non-allergist-delivered penicillin allergy de-labelling (PADL) is supported by UK and other national guidelines but is not yet routine practice in UK hospitals. Those who have undergone PADL report high rates of acceptance, but …
View article: Developing a model for decision-making around antibiotic prescribing for patients with COVID-19 pneumonia in acute NHS hospitals during the first wave of the COVID-19 pandemic: qualitative results from the Procalcitonin Evaluation of Antibiotic use in COVID-19 Hospitalised patients (PEACH Study)
Developing a model for decision-making around antibiotic prescribing for patients with COVID-19 pneumonia in acute NHS hospitals during the first wave of the COVID-19 pandemic: qualitative results from the Procalcitonin Evaluation of Antibiotic use in COVID-19 Hospitalised patients (PEACH Study) Open
Objective To explore and model factors affecting antibiotic prescribing decision-making early in the pandemic. Design Semistructured qualitative interview study. Setting National Health Service (NHS) trusts/health boards in England and Wal…
View article: Management of BAME patients with a history of penicillin allergy: barriers to best practice and strategies to overcome these
Management of BAME patients with a history of penicillin allergy: barriers to best practice and strategies to overcome these Open
View article: Penicillin allergy de-labelling by non-allergists: a comparison of testing protocols
Penicillin allergy de-labelling by non-allergists: a comparison of testing protocols Open
Optimizing penicillin allergy de-labelling (PADL) to ensure patients with an incorrect penicillin allergy record are de-labelled with minimal patient harm is important for antibiotic stewardship. The heterogeneity of inclusion and exclusio…
View article: Issue Information
Issue Information Open
View article: Removal of incorrect penicillin allergy labels in a UK hospital
Removal of incorrect penicillin allergy labels in a UK hospital Open