Direct Oral Challenge for Penicillin Allergy: A Hospital Implementation Evaluation Via the International Network of Antibiotic Allergy Nations (iNAAN) Study.

Mitri, Elise A; Vogrin, Sara; Paynter, Camille; Fletcher, Luke R; Peter, Jonny; Powell, Neil; Barnes, Sara; Li, Philip H et al. · Clin Infect Dis · 2026

prospective_cohort · Level II

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Abstract

In this international, multicenter prospective study, implementing penicillin direct oral challenge (DOC) using a digital toolkit was acceptable, feasible, and sustainable. Audit and feedback increased activity, particularly among pharmacists. Safety was maintained across heterogeneous DOC protocols, validating a pragmatic, scalable approach that supports local adaptation.