BACKGROUND: Cephalosporins can cause allergic reactions in patients with penicillin (PCN) allergy. Physicians' prescribing habits for patients with PCN allergy can vary. OBJECTIVES: 1) Survey community and academic physicians, students, residents, and allergists on their tendencies to prescribe cephalosporins and/or perform PCN skin testing in patients with different histories of PCN allergy. 2) Evaluate PCN allergy knowledge in these groups. METHODS: A questionnaire consisting of four case scenarios and five true/false questions on PCN allergy was distributed at various conferences and by mailings. RESULTS: Three hundred seventy-eight completed surveys were analyzed. Given a patient with a history of rash with PCN, an equal number of allergists and nonallergists (36%) prescribed cephalosporins, although there was a difference between pediatricians (56%) and internists (22%). Given a history of PCN anaphylaxis, no allergists but 11% of nonallergists prescribed a cephalosporin. Skin testing was infrequently requested by nonallergists. The correct response rate for the true/false questions was 89% for allergists, community (63%) and academic (67%) physicians, pediatricians (61%), internists (67%), residents (68%), and students (68%). Pediatric residents had the highest (74%) and community pediatricians the lowest (59%) correct response rate. CONCLUSIONS: There is marked variation in prescribing cephalosporins and in requesting PCN skin testing in patients with varied histories of PCN allergy. The survey results indicate a need for increased PCN allergy education.
BACKGROUND:Cephalosporins can cause allergic reactions in patients with penicillin (PCN) allergy. Physicians' prescribing habits for patients with PCN allergy can vary. OBJECTIVES: 1) Survey community and academic physicians, students, residents, and allergists on their tendencies to prescribe cephalosporins and/or perform PCN skin testing in patients with different histories of PCN allergy. 2) Evaluate PCN allergy knowledge in these groups. METHODS: A questionnaire consisting of four case scenarios and five true/false questions on PCN allergy was distributed at various conferences and by mailings. RESULTS: Three hundred seventy-eight completed surveys were analyzed. Given a patient with a history of rash with PCN, an equal number of allergists and nonallergists (36%) prescribed cephalosporins, although there was a difference between pediatricians (56%) and internists (22%). Given a history of PCN anaphylaxis, no allergists but 11% of nonallergists prescribed a cephalosporin. Skin testing was infrequently requested by nonallergists. The correct response rate for the true/false questions was 89% for allergists, community (63%) and academic (67%) physicians, pediatricians (61%), internists (67%), residents (68%), and students (68%). Pediatric residents had the highest (74%) and community pediatricians the lowest (59%) correct response rate. CONCLUSIONS: There is marked variation in prescribing cephalosporins and in requesting PCN skin testing in patients with varied histories of PCN allergy. The survey results indicate a need for increased PCN allergy education.
Authors: Kimberly G Blumenthal; Erica S Shenoy; Christy A Varughese; Shelley Hurwitz; David C Hooper; Aleena Banerji Journal: Ann Allergy Asthma Immunol Date: 2015-06-09 Impact factor: 6.347
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