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National Clinical Guideline Centre (UK). Drug Allergy: Diagnosis and Management of Drug Allergy in Adults, Children and Young People. London: National Institute for Health and Care Excellence (NICE); 2014 Sep. (NICE Clinical Guidelines, No. 183.)

Cover of Drug Allergy

Drug Allergy: Diagnosis and Management of Drug Allergy in Adults, Children and Young People.

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Appendix EClinical article selection

E.1. Assessment

What is the clinical and cost effectiveness of clinical probability scores or algorithms in identifying or excluding drug allergies?

Figure 1. Flow chart of clinical article selection for the review of algorithms.

Figure 1Flow chart of clinical article selection for the review of algorithms

E.2. Measuring serum tryptase after suspected anaphylaxis

What is the clinical and cost effectiveness of serum tryptase testing compared with reference standard tests for the diagnosis of an anaphylactic reaction due to suspected drug allergy?

Figure 2. Flow chart of clinical article selection for the review of serum tryptase testing.

Figure 2Flow chart of clinical article selection for the review of serum tryptase testing

E.3. Measuring serum specific IgE

What is the clinical and cost effectiveness of serum specific IgE testing compared with reference standard tests in the diagnosis of drug allergy for the following drugs: amoxicillin, ampicillin, cefaclor, chlorhexidine, morphine, penicillin G, penicillin V, suxamethonium?

Figure 3. Flow chart of clinical article selection for the review of serum specific IgE testing.

Figure 3Flow chart of clinical article selection for the review of serum specific IgE testing

E.4. Documenting and sharing information with other healthcare professionals

What are the most clinically and cost effective documentation strategies for communicating drug allergy information across all NHS services to prevent patients from receiving drugs to which they are allergic?

Figure 4. Flow diagram of clinical article selection for the review of documentation strategies.

Figure 4Flow diagram of clinical article selection for the review of documentation strategies

E.5. Providing information and support to patients

What information and support should individuals with suspected drug allergy or their parents or carers receive?

What information and support should individuals who have had specialist investigations or their parents or carers receive?

Figure 5. Flow chart of clinical article selection for the review of patient information and support.

Figure 5Flow chart of clinical article selection for the review of patient information and support

E.6. Non-specialist management – selective COX-2 inhibitors

In patients who have had an allergic reaction to NSAIDs what are the factors that indicate whether people can or cannot tolerate selective COX-2 inhibitors?

Figure 6. Flow chart of clinical article selection for the review of toleration of selective COX-2 inhibitors.

Figure 6Flow chart of clinical article selection for the review of toleration of selective COX-2 inhibitors

E.7. Referral to specialist drug allergy services

What is the clinical and cost effectiveness of referral to specialist drug allergy services for people with suspected allergy to beta-lactam antibiotics?

What is the clinical and cost effectiveness of referral to specialist drug allergy services for people with suspected allergy to NSAIDs?

What is the clinical and cost effectiveness of referral to specialist drug allergy services for people with suspected allergy to local anaesthetics?

What is the clinical and cost effectiveness of referral to specialist drug allergy services for people with suspected anaphylaxis due to drug allergy during general anaesthesia?

Figure 7. Flow chart of clinical article selection for the review of referral to specialist drug allergy services.

Figure 7Flow chart of clinical article selection for the review of referral to specialist drug allergy services

Copyright © National Clinical Guideline Centre, 2014.
Bookshelf ID: NBK274141

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