BACKGROUND: Over 90% of patients with a history of penicillin allergy have negative penicillin skin tests. Pharmacists are trained to identify and resolve medication-related problems. We hypothesized that collaboration between allergists and pharmacists to identify and evaluate patients with a history of penicillin allergy would increase β-lactam antibiotic prescription. METHODS: We conducted a prospective observational study in which patients with a history of penicillin allergy were identified and educated at the pharmacy about penicillin allergy and offered an allergist consultation with a penicillin skin test. All patients were followed up to determine which antibiotics were subsequently prescribed. RESULTS: A total of 503 patients were enrolled, and 71 (14%) were evaluated by an allergist. Sixty-seven of these 71 patients (94%) had a negative penicillin skin test. Twenty-nine patients evaluated by an allergist and 205 patients not evaluated were prescribed antibiotics. Patients prescribed antibiotics and evaluated by an allergist were compared to those not evaluated by an allergist, with the following results: 19 of 29 patients (66%) were prescribed a β-lactam antibiotic compared to 54 of 205 (26%; p < 0.0001); 8 of 29 patients (28%) were prescribed penicillin compared to 7 of 205 (3%; p < 0.0001); 15 of 29 patients (52%) were prescribed a cephalosporin compared to 48 of 205 (23%; p < 0.01), and 10 of 29 patients (34%) were prescribed a non-β-lactam antibiotic compared with 177 of 205 (86%; p < 0.0001). CONCLUSION: A collaborative effort between allergists and pharmacists can increase β-lactam antibiotic prescriptions and decrease non-β-lactam prescriptions in patients with a history of penicillin allergy.
BACKGROUND: Over 90% of patients with a history of penicillinallergy have negative penicillin skin tests. Pharmacists are trained to identify and resolve medication-related problems. We hypothesized that collaboration between allergists and pharmacists to identify and evaluate patients with a history of penicillinallergy would increase β-lactam antibiotic prescription. METHODS: We conducted a prospective observational study in which patients with a history of penicillinallergy were identified and educated at the pharmacy about penicillinallergy and offered an allergist consultation with a penicillin skin test. All patients were followed up to determine which antibiotics were subsequently prescribed. RESULTS: A total of 503 patients were enrolled, and 71 (14%) were evaluated by an allergist. Sixty-seven of these 71 patients (94%) had a negative penicillin skin test. Twenty-nine patients evaluated by an allergist and 205 patients not evaluated were prescribed antibiotics. Patients prescribed antibiotics and evaluated by an allergist were compared to those not evaluated by an allergist, with the following results: 19 of 29 patients (66%) were prescribed a β-lactam antibiotic compared to 54 of 205 (26%; p < 0.0001); 8 of 29 patients (28%) were prescribed penicillin compared to 7 of 205 (3%; p < 0.0001); 15 of 29 patients (52%) were prescribed a cephalosporin compared to 48 of 205 (23%; p < 0.01), and 10 of 29 patients (34%) were prescribed a non-β-lactam antibiotic compared with 177 of 205 (86%; p < 0.0001). CONCLUSION: A collaborative effort between allergists and pharmacists can increase β-lactam antibiotic prescriptions and decrease non-β-lactam prescriptions in patients with a history of penicillinallergy.
Authors: Anca M Chiriac; Aleena Banerji; Rebecca S Gruchalla; Bernard Y H Thong; Paige Wickner; Paul-Michel Mertes; Ingrid Terreehorst; Kimberly G Blumenthal Journal: J Allergy Clin Immunol Pract Date: 2018-12-17
Authors: Tamar F Barlam; Sara E Cosgrove; Lilian M Abbo; Conan MacDougall; Audrey N Schuetz; Edward J Septimus; Arjun Srinivasan; Timothy H Dellit; Yngve T Falck-Ytter; Neil O Fishman; Cindy W Hamilton; Timothy C Jenkins; Pamela A Lipsett; Preeti N Malani; Larissa S May; Gregory J Moran; Melinda M Neuhauser; Jason G Newland; Christopher A Ohl; Matthew H Samore; Susan K Seo; Kavita K Trivedi Journal: Clin Infect Dis Date: 2016-04-13 Impact factor: 9.079
Authors: Jason A Trubiano; Cosby A Stone; M Lindsay Grayson; Karen Urbancic; Monica A Slavin; Karin A Thursky; Elizabeth J Phillips Journal: J Allergy Clin Immunol Pract Date: 2017-08-23
Authors: Mary L Staicu; David Vyles; Erica S Shenoy; Cosby A Stone; Taylor Banks; Kristin S Alvarez; Kimberly G Blumenthal Journal: J Allergy Clin Immunol Pract Date: 2020-10
Authors: Jason A Trubiano; Karin A Thursky; Andrew J Stewardson; Karen Urbancic; Leon J Worth; Cheryl Jackson; Wendy Stevenson; Michael Sutherland; Monica A Slavin; M Lindsay Grayson; Elizabeth J Phillips Journal: Clin Infect Dis Date: 2017-07-01 Impact factor: 9.079