The ALABAMA Trial
Allergy Antibiotics and Microbial Resistance
The University of Leeds and University of Oxford are carrying out a research study aimed at finding out:
- If people with a penicillin-allergy label in their GP health records really do have an allergy by specialist PAAP (Penicillin-Allergy Assessment Pathway) testing.
- If we can reduce the number of patients wrongly labelled as penicillin allergic.
- We will find out if this results in better use of antibiotics and fewer days of symptoms, when patients are prescribed antibiotics for infection.
We are asking GPs in West Yorkshire to help us with this research, we have completed the initial feasibility study and hope to include 2,090 participants in the main study (including feasibility participants).
Patients with medical records that state that they are allergic to penicillin antibiotics, are over 18 years old, and have taken an antibiotic in the previous 24 months will be invited to take part in the ALABAMA trial. Eligible patients who would like to proceed will be asked to sign a consent form before participating in the study. Patients will be randomly allocated to either the Penicillin Allergy Assessment Pathway (PAAP) study group or usual care.
Patients assigned to the usual care group, will not be required to attend any further visits for the purpose of the trial. Patients assigned to the PAAP study group will be asked to attend one clinic appointment at their local Immunology Centre. This appointment will involve a patient questionnaire to assess risk of anaphylaxis, either a skin test or straight to the ‘oral challenge’ test. The oral challenge test involves three doses of penicillin in an hour. Patients will be monitored closely throughout this time and also one hour after the last dose. If there is no reaction to the oral test, patients will be asked to take penicillin at home for 3 days. Patients will receive the results of the PAAP test via letter within 3 days. GPs will be informed of the test results and will update their health records as needed. Patients will be followed up by phone call twice within 30 days post-PAAP.
Both usual care and PAAP groups if prescribed an antibiotic by their GP within 12 months after being entered into the study, will be asked to complete a daily symptom diary for up to 28 days. After 12 months a member of the study team will call patients to complete a final quality of life questionnaire. A few selected participants and practice staff will be invited to take part in a telephone interview as well.
For more information please see the further information section below. Alternatively, please contact the study team on the details below:
Chief Investigator: Dr Jonathan Sandoe
Local Contact: Mina Davoudianfar (Trial Manager)
Tel: 07917 207866
NIHR Programme Grants for Applied Research (RP-PG-1214-20007)
- Prof Sue Pavitt, University of Leeds
- Prof Chris Butler, University of Oxford
- Dr Ly-Mee Yu, University of Oxford
- Prof Philip Howard, Leeds Teaching Hospitals Trust
- Dr Sarah Tonkin-Crine, University of Oxford
- Dr Sinisa Savic, Leeds Teaching Hospitals Trust
- Ms Jenny Boards, PPI Representative
- Dr Bethany Shinkins, University of Leeds
- Dr Emily Bongard, University of Oxford
- Ms Mina Davoudianfar, University of Oxford
- Dr Marta Wanat, University of Oxford
GP practices involved
- Gibson Lane Practice
- Craven Road Medical Practice
- Fieldhead Surgery
- Whitehall Surgery
- Hillfoot Surgery
- Kippax Hall Surgery
- Hillside Bridge
- Garforth Medical Practice
- Moorfield House
- Gables Surgery
- Windmill Health Centre
- Spa Surgery
- Hyde Park Surgery
- The Moss Practice
- Saltaire & Windhill Medical Practice
- Guiseley & Yeadon Medical Practice
- Orchard Croft Medical Centre
- Trinity Medical Centre (inc. Sandal Castle Medical Centre)
- Blackburn Road Medical Centre
- Springbank Surgery
- Friarwood Surgery
- Eightlands Surgery
- Healthcare First
- Queen Street Surgery
- Park View Surgery
- Fisher Medical Centre
- Chevin Medical Practice
- Silsden Medical Practice
- Stockwell Road Surgery