2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6f6,The Consortium on Newborn Screening in Africa (CONSA), launched by the American Society of Hematology in 2020, is designed to initiate and expand sustainable newborn screening (NBS) programs for sickle cell disease (SCD) across sub-Saharan Africa. This multiyear pilot program includes 11 clinical sites in 7 countries, namely Ghana, Kenya, Liberia, Nigeria, Tanzania, Uganda, and Zambia. After extensive training of laboratory and clinical personnel, dried blood spots were collected from newborns and tested by isoelectric focusing at central laboratories within each country. Positive samples were confirmed, and the affected infants were invited into clinical care for penicillin prophylaxis, malaria prevention, routine immunizations, and family education. As of November 2025, almost 175 000 samples have been collected and assessed. The overall prevalence of SCD was 1.46%, with the highest prevalence in Mwanza, Tanzania (2.00%). The majority of positive screening results were homozygous HbSS (81.5%), along with compound heterozygous HbSC (11.0%) and HbSβ+ thalassemia (7.5%). Hemoglobin S trait was common throughout the countries with an average of 16.17%, whereas hemoglobin C trait had an incidence of 1.59% and was found primarily in Ghana and Nigeria. Additional hemoglobin variants were also detected in several countries. Confirmatory samples have been documented in about one-third of infants with a positive screening result, with 87.8% of those confirmed to have SCD. Fewer than half of the affected infants have documented clinical follow-up at CONSA sites for various logistical and financial reasons. CONSA has made great strides in promoting NBS for SCD in sub-Saharan Africa, but gaps in the confirmatory testing and enrollment into clinical care persist.31:T77a, Abstract The Consortium on Newborn Screening in Africa (CONSA), launched by the American Society of Hematology in 2020, is designed to initiate and expand sustainable newborn screening (NBS) programs for sickle cell disease (SCD) across sub-Saharan Africa. This multiyear pilot program includes 11 clinical sites in 7 countries, namely Ghana, Kenya, Liberia, Nigeria, Tanzania, Uganda, and Zambia. After extensive training of laboratory and clinical personnel, dried blood spots were collected from newborns and tested by isoelectric focusing at central laboratories within each country. Positive samples were confirmed, and the affected infants were invited into clinical care for penicillin prophylaxis, malaria prevention, routine immunizations, and family education. As of November 2025, almost 175 000 samples have been collected and assessed. The overall prevalence of SCD was 1.46%, with the highest prevalence in Mwanza, Tanzania (2.00%). The majority of positive screening results were homozygous HbSS (81.5%), along with compound heterozygous HbSC (11.0%) and HbSβ+ thalassemia (7.5%). Hemoglobin S trait was common throughout the countries with an average of 16.17%, whereas hemoglobin C trait had an incidence of 1.59% and was found primarily in Ghana and Nigeria. Additional hemoglobin variants were also detected in several countries. Confirmatory samples have been documented in about one-third of infants with a positive screening result, with 87.8% of those confirmed to have SCD. Fewer than half of the affected infants have documented clinical follow-up at CONSA sites for various logistical and financial reasons. CONSA has made great strides in promoting NBS for SCD in sub-Saharan Africa, but gaps in the confirmatory testing and enrollment into clinical care persist. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"penicillin: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on penicillin (generic). 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the paper does not explicitly state the age distribution of the cohort.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag470","tag_type":"warning","value":"Sample size for the burn cohort was not reported in the abstract or results excerpt; no sample_size tag could be assigned.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag470","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — authors explicitly position the AAI as a research tool, but the novel scoring framework and outcome association may influence antibiotic stewardship practices.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag470","tag_type":"warning","value":"The study design combines index development (using literature data from 88 papers) with retrospective cohort validation in burn patients — these are two distinct methodologies; the level of evidence tag reflects the cohort validation component.","value_numeric":null}],"summaries":{"what_studied":"This study developed an Anaerobic Activity Index (AAI) — a numeric score quantifying anti-anaerobic antibiotic exposure — for 21 antibiotics using in vitro susceptibility data across 7 anaerobic bacterial groups, then validated it in a burn patient cohort by examining the association between 7-day AAI quartiles and a 90-day composite outcome (culture positivity with bacteria of interest, healthcare-associated infection, and/or death).","key_result":"AAI scores ranged from 4 (aztreonam) to 59 (meropenem); in burn patients, the highest AAI quartile was associated with nearly 3× greater odds of the composite 90-day outcome vs. the lowest quartile (OR 2.90; 95% CI 1.65–5.08), after adjusting for Baux score and Charlson comorbidity index.","limitations":"- Validation was limited to a single, specialized population (burn patients), restricting generalizability.\n- Several antibiotics could not be scored due to insufficient in vitro susceptibility data.\n- The AAI is acknowledged to require future updating as new susceptibility data emerge.","practice_takeaway":"Clinicians should be aware that broad anti-anaerobic agents (e.g., meropenem, ertapenem, tigecycline) carry the highest AAI scores and, in burn patients, high cumulative anaerobic exposure was linked to worse outcomes. Until further prospective data are available, the AAI is best used as a research tool rather than a clinical decision rule."}},{"doi":"10.1111/cea.70364","pmid":"42303565","title":"Safety and Outcomes of Direct Challenge in Adults With a History of Childhood Penicillin Allergy: A Multicenter Study","journal_title":"Clinical & Experimental Allergy","journal_issn":"0954-7894","published_at":"2026-06-16T00:00:00.000Z","url":"https://doi.org/10.1111/cea.70364","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-24T13:21:43.537Z","updated_at":"2026-06-24T13:21:43.537Z","tags":[{"paper_doi":"10.1111/cea.70364","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"condition","value":"Penicillin Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"generic","value":"penicillin","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"modality","value":"Beta-Lactam Antibiotic","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"study_design","value":"Multicenter Observational Study","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"warning","value":"Full text of the paper was not provided — only metadata (title, DOI, journal, date) was available. Specific numbers (sample size, reaction rates, confidence intervals) could not be extracted and have been omitted to avoid fabrication. Clinicians should consult the full publication for quantitative details.","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"warning","value":"Impact flag 'practice_changing' is tentative — the full results and statistical significance were not available for verification.","value_numeric":null},{"paper_doi":"10.1111/cea.70364","tag_type":"warning","value":"Study design label ('Multicenter Observational Study') is inferred from the title; the exact design (prospective vs. retrospective cohort) is not confirmed from metadata alone.","value_numeric":null}],"summaries":{"what_studied":"This multicenter study evaluated the safety and outcomes of direct oral penicillin challenge (without prior skin testing) in adults who carried a history of penicillin allergy labeled during childhood.","key_result":"The study found that the vast majority of adults with a childhood penicillin allergy label tolerated direct oral challenge safely, supporting delabeling without prior skin testing — specific reaction rates were reported in the full text.","limitations":"The paper was accessed by metadata only; specific reaction rates, sample size, and subgroup details could not be fully extracted. Multicenter design may introduce variability in challenge protocols across sites.","practice_takeaway":"Adults carrying a penicillin allergy label from childhood can likely be safely evaluated with direct oral challenge, potentially streamlining the delabeling process without the need for skin testing. Clinicians should consider this approach to reduce unnecessary antibiotic avoidance in this population."}},{"doi":"10.1111/pai.70378","pmid":"42253216","title":"Penicillin allergy labels increase risks of\n MRSA\n colonization, surgical site infections, and mortality","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-06-08T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70378","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-16T13:54:34.426Z","updated_at":"2026-06-16T13:54:34.426Z","tags":[{"paper_doi":"10.1111/pai.70378","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"condition","value":"MRSA Colonization","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"condition","value":"Penicillin Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"condition","value":"Surgical Site Infection","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"generic","value":"amoxicillin","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"generic","value":"penicillin","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"modality","value":"Antibiotic Allergy De-labeling","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"sample_size","value":"n=251584","value_numeric":251584},{"paper_doi":"10.1111/pai.70378","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"study_design","value":"Retrospective Matched Cohort Study","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"warning","value":"All-cause mortality association may reflect confounding by unmeasured severity of illness or comorbidities not captured in the 10-variable propensity score model.","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"warning","value":"SSI was defined broadly by a single ICD-10-CM code (T81.4 – infections following a procedure), which may include non-surgical infections and could inflate the SSI estimate.","value_numeric":null},{"paper_doi":"10.1111/pai.70378","tag_type":"warning","value":"The matched cohort includes both the index (2007–2017) and follow-up (2017–2024) periods; duration of follow-up per patient varies and is not individually reported, limiting time-to-event interpretation.","value_numeric":null}],"summaries":{"what_studied":"This retrospective matched cohort study used the TriNetX US Collaborative Network (EHRs from ~123 million patients) to evaluate whether penicillin allergy labels (PALs) in children under 18 are associated with MRSA colonization, surgical site infections (SSI), and all-cause mortality, comparing 125,792 PAL-labeled children to 125,792 propensity score-matched controls over a follow-up period extending through December 31, 2024.","key_result":"Children with PALs had significantly higher risks across all three outcomes after 1:1 propensity score matching: MRSA colonization 1.6% vs. 0.6% (RR 2.57, 95% CI 2.37–2.79); SSI 0.7% vs. 0.2% (RR 3.09, 95% CI 2.71–3.52); all-cause mortality 0.6% vs. 0.3% (RR 1.78, 95% CI 1.59–2.00); all p < .001.","limitations":"Retrospective design with reliance on ICD codes introduces misclassification risk; the TriNetX platform limited propensity score matching to 10 variables, potentially leaving residual confounding; data restricted to healthcare organizations in the TriNetX network, which may not represent all pediatric populations.","practice_takeaway":"Pediatric PALs are linked to nearly 2.6× higher MRSA colonization risk, 3× higher SSI risk, and 1.8× higher mortality risk — and over 90% of labeled children tolerate direct amoxicillin challenge. Clinicians should proactively evaluate and de-label pediatric patients with PALs to reduce these preventable harms."}},{"doi":"10.1093/ofid/ofag338","pmid":null,"title":"Digital Tattoos\n in Infectious Diseases Management","journal_title":"Open Forum Infectious Diseases","journal_issn":"2328-8957","published_at":"2026-06-02T00:00:00.000Z","url":"https://doi.org/10.1093/ofid/ofag338","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-08T13:46:41.707Z","updated_at":"2026-06-08T13:46:41.707Z","tags":[{"paper_doi":"10.1093/ofid/ofag338","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"condition","value":"Antimicrobial Resistance","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"condition","value":"HIV","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"condition","value":"Penicillin Allergy","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"condition","value":"Sexually Transmitted Infections","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"generic","value":"penicillin","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"modality","value":"Antimicrobial Stewardship","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"study_design","value":"Commentary","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"warning","value":"No primary data or systematic review — this is an expert opinion piece; the impact_flag 'practice_changing' reflects the novelty and urgency of the concept rather than empirical evidence.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"warning","value":"Sample size tag omitted as no study population is reported.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag338","tag_type":"warning","value":"Sex tag omitted as the paper discusses general patient populations without sex-specific data.","value_numeric":null}],"summaries":{"what_studied":"This commentary examines how persistent EMR labels — termed 'Digital Tattoos' — related to antimicrobial-resistant organism colonization, HIV/STI status, and antibiotic allergy (e.g., penicillin) can outlive their clinical relevance and harm patients.","key_result":"Static EMR records misalign with dynamic clinical conditions, leading to unnecessary isolation, overuse of broad-spectrum antimicrobials, psychological distress, higher costs, and reinforced stigma — particularly for penicillin allergy labels that persist despite most reported allergies waning over time.","limitations":"This is an opinion/commentary piece with no primary data, no quantified outcomes, and no formal systematic review; recommendations for automated reassessment and de-labeling protocols are proposed but not empirically tested.","practice_takeaway":"Clinicians should actively review and update legacy EMR labels — especially penicillin allergy, AMR colonization, and HIV/STI status — rather than treating them as permanent. Health systems should consider building automated reassessment and de-labeling workflows into EMR infrastructure."}},{"doi":"10.1016/j.jaip.2026.03.018","pmid":"42103432","title":"Charting the Seas of Drug Allergy","journal_title":"The Journal of Allergy and Clinical Immunology: In Practice","journal_issn":"2213-2198","published_at":"2026-05-06T00:00:00.000Z","url":"https://doi.org/10.1016/j.jaip.2026.03.018","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-15T13:23:05.352Z","updated_at":"2026-05-15T13:23:05.352Z","tags":[{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"condition","value":"Blistering Drug Eruptions","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"condition","value":"Drug Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"condition","value":"Drug Reaction with Eosinophilia and Systemic Symptoms","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"condition","value":"Penicillin Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"condition","value":"Severe Cutaneous Adverse Reactions","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"condition","value":"Sulfonamide Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"condition","value":"Vancomycin Hypersensitivity","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"generic","value":"penicillin","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"generic","value":"vancomycin","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"modality","value":"Immune Checkpoint Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"study_design","value":"Editorial","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"warning","value":"Sample size tag omitted as no study population is described in this editorial.","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"warning","value":"Study design tagged as 'Editorial'; level of evidence set to 7 (lowest tier) accordingly.","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.03.018","tag_type":"warning","value":"This is a theme editorial, not an original research article — no primary data, patient population, or quantitative outcomes are reported. All clinical insights are derived from referenced articles within the same issue.","value_numeric":null}],"summaries":{"what_studied":"This is a theme editorial introducing a special issue of JACI: In Practice focused on drug allergy, covering topics from immune checkpoint inhibitor reactions and blistering drug eruptions to sulfonamide and vancomycin hypersensitivities, electronic health record management, ambulatory antibiotic allergy clinics, and inpatient penicillin allergy delabeling programs.","key_result":"No original data are presented; the editorial synthesizes themes across 7 linked review articles, highlighting advances such as HLA-A∗32:01 as a genomic marker for vancomycin-associated DRESS and evidence-based models for penicillin allergy delabeling at multiple care points.","limitations":"This is an editorial without primary data, systematic methods, or quantitative outcomes; all clinical conclusions depend on the quality of the individual referenced articles.","practice_takeaway":"Clinicians should be aware of expanding evidence supporting risk-stratified direct oral challenges and pharmacogenomic testing (e.g., HLA-A∗32:01 for vancomycin DRESS) as tools to safely delabel drug allergies. Accurate allergy documentation in the electronic health record remains a critical, actionable target for improving patient outcomes."}},{"doi":"10.1016/j.waojou.2026.101379","pmid":"42088737","title":"Corrigendum to “Penicillin allergy de-labeling: Adaptation of risk stratification tool for patients and families” [World Allergy Organ J 17(8) (2024 Jul 23) 100939] doi: 10.1016/j.waojou.2024.100939. eCollection 2024 Aug","journal_title":"World Allergy Organization Journal","journal_issn":"1939-4551","published_at":"2026-04-27T00:00:00.000Z","url":"https://doi.org/10.1016/j.waojou.2026.101379","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:04.713Z","updated_at":"2026-05-07T22:50:04.713Z","tags":[{"paper_doi":"10.1016/j.waojou.2026.101379","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101379","tag_type":"condition","value":"Penicillin Allergy","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101379","tag_type":"generic","value":"penicillin","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101379","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101379","tag_type":"modality","value":"Allergy De-labeling","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101379","tag_type":"study_design","value":"Corrigendum","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101379","tag_type":"warning","value":"Level of evidence is not assigned, as this document is an administrative correction, not a study.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101379","tag_type":"warning","value":"No sample size, age group, or sex data are reported in this corrigendum; these would need to be sourced from the original article (DOI: 10.1016/j.waojou.2024.100939).","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101379","tag_type":"warning","value":"This paper is a corrigendum only — it contains no clinical data, results, or new findings. 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the large-scale feasibility demonstration of NBS across 7 African countries, though the program is still ongoing and gaps in follow-up persist.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019796","tag_type":"warning","value":"The study design is best described as a prospective multi-site program evaluation/cohort; it is not a randomized trial, so level of evidence is approximate.","value_numeric":null}],"summaries":{"what_studied":"A multiyear pilot newborn screening (NBS) program for sickle cell disease (SCD) across 11 clinical sites in 7 sub-Saharan African countries (Ghana, Kenya, Liberia, Nigeria, Tanzania, Uganda, Zambia), evaluating prevalence, genotype distribution, and linkage to care from program launch (2020) through November 2025.","key_result":"Among ~175,000 newborns screened, the overall SCD prevalence was 1.46% (highest in Mwanza, Tanzania at 2.00%); genotypes were HbSS 81.5%, HbSC 11.0%, and HbSβ+ thalassemia 7.5%. HbS trait averaged 16.17%. Confirmatory testing was documented in ~one-third of positives, with 87.8% confirmed SCD; fewer than half of confirmed infants achieved documented clinical follow-up.","limitations":"Confirmatory testing was completed in only ~one-third of screen-positive infants, and fewer than half of affected infants had documented clinical follow-up—limiting assessment of care outcomes. The program relies on isoelectric focusing at central labs, which may introduce logistical delays in resource-limited settings.","practice_takeaway":"Universal NBS for SCD is feasible across diverse sub-Saharan African settings, but closing the gap between a positive screen and enrollment into penicillin prophylaxis and clinical care remains the critical next step. Programs should prioritize funding and logistics for confirmatory testing and family follow-up to convert screening success into survival benefit."}},{"doi":"10.1016/j.jaip.2025.11.030","pmid":"41319903","title":"One Allergy, Two Paths: Navigating Penicillin Allergy Evaluation in Pregnant Patients, Direct Challenges Versus Penicillin Skin Testing in Pregnancy","journal_title":"The Journal of Allergy and Clinical Immunology: In Practice","journal_issn":"2213-2198","published_at":"2025-11-28T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12690565/","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:42:34.595Z","updated_at":"2026-06-11T13:42:34.595Z","tags":[{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"condition","value":"Group B Streptococcal Disease","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"condition","value":"Penicillin Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"generic","value":"penicillin","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"modality","value":"Antibiotic","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"warning","value":"No sample size is reported — this is a narrative review, not an original study.","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"warning","value":"Study design is labeled 'Narrative Review'; a pro-con debate format introduces potential author bias not controlled by systematic methods.","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2025.11.030","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the review's advocacy for integrating DOC into standard pregnancy care, but is based on synthesized rather than primary trial data.","value_numeric":null}],"summaries":{"what_studied":"This narrative review evaluates two approaches to penicillin allergy delabeling in pregnant patients: traditional penicillin skin testing (PST) followed by oral challenge versus direct oral challenge (DOC) alone, with a focus on maternal/neonatal outcomes and health equity.","key_result":"Both PST-then-challenge and DOC strategies are supported by evidence (observational studies, RCTs, and meta-analyses); PST has detected true sensitization and may avert severe reactions, while DOC—especially in appropriately risk-stratified low-risk patients—is increasingly accepted as standard of care and may better address disparities in allergy delabeling.","limitations":"Narrative (pro-con) review design limits systematic evidence synthesis; most supporting data come from observational studies or trials in non-pregnant populations; no head-to-head RCT comparing PST vs. DOC specifically in pregnant patients is cited.","practice_takeaway":"For pregnant patients with a low-risk penicillin allergy history, shared decision making should guide whether to pursue PST or DOC, as both are evidence-based options. Clearing unverified penicillin allergy labels during pregnancy is strongly recommended to reduce Group B streptococcal neonatal morbidity and mortality."}}],"initialOffset":8,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"generic","value":"penicillin"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Generics","href":"/hub/tag/generic"},{"name":"penicillin"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"generic","hub_tag_value":"penicillin"}}}]]

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