sulf_fast_score: SULF-FAST Penicillin Allergy Decision Rule

In cliot: Clinical Indices and Outcomes Tools

SULF-FAST Penicillin Allergy Decision Rule

Description

Calculates the SULF-FAST score to stratify the risk of a true Trimethoprim-Sulfamethoxazole (TMP-SMX) allergy. The score helps identify patients who may be candidates for direct oral challenge versus those requiring further evaluation.

Usage

sulf_fast_score(reaction_lt_5_years, anaphylaxis_or_angioedema,
                severe_cutaneous_adverse_reaction, organ_involvement)

Arguments

reaction_lt_5_years	Numeric (0 or 1). Did the reaction occur less than 5 years ago? (1 = Yes, +2 points).
anaphylaxis_or_angioedema	Numeric (0 or 1). Did the reaction involve anaphylaxis or angioedema? (1 = Yes, +2 points).
severe_cutaneous_adverse_reaction	Numeric (0 or 1). Is there a history of Severe Cutaneous Adverse Reaction (SCAR) such as SJS, TEN, or DRESS? (1 = Yes, +1 point).
organ_involvement	Numeric (0 or 1). Did the reaction involve internal organs (e.g., hepatitis, nephritis, pneumonitis, cytopenias)? (1 = Yes, +2 points).

Value

A list containing:

SULF_FAST_Score	The calculated total score (Range 0-7).
Risk_Category	Risk stratification (Low Risk <= 2, High Risk >= 3).
Recommendation	Clinical guidance regarding oral challenge.

References

Trubiano JA, et al. The SULF-FAST antibiotic allergy clinical decision rule. J Allergy Clin Immunol Pract. 2023.

Examples

# Example 1: Low Risk
# Reaction > 5 years ago (0), No anaphylaxis (0), No SCAR (0), No organ involvement (0)
# Score = 0
sulf_fast_score(0, 0, 0, 0)

# Example 2: High Risk
# Reaction < 5 years (2), Anaphylaxis (2)
# Score = 4
sulf_fast_score(1, 1, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.