Bryan G Shaw1, Inela Masic2, Nancy Gorgi2, Niree Kalfayan2, Elise M Gilbert1,3, Viktorija O Barr1,4, Michael G Ison5,6, Milena M McLaughlin1,2. 1. Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA. 2. Department of Pharmacy Practice, Midwestern University, Chicago College of Pharmacy, Downers Grove, IL, USA. 3. Department of Pharmacy Practice, Chicago State University College of Pharmacy, Chicago, IL, USA. 4. Department of Pharmacy Practice, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA. 5. Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 6. Department of Surgery, Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Abstract
BACKGROUND: Many patients with a self-reported penicillin allergy go on to tolerate beta-lactam antibiotics. Allergy specialists may be consulted to determine the nature and extent of the allergy. However, electronic allergy records must be appropriately updated such that recommendations are carried forward. OBJECTIVE: To determine the percentage of patients who have their electronic allergy record updated after an allergy service consult (ASC). METHODS: This was a retrospective study of patients with at least 1 documented beta-lactam allergy and had an ASC during (inpatient) or prior to (outpatient) hospital admission at Northwestern Memorial Hospital and Prentice Women's Hospital in Chicago, Illinois. RESULTS: Within the study period, a total of 26 526 patients were identified as having a documented antibiotic allergy, with 21 657 patients (81.6% of patients with allergies) having a listed beta-lactam allergy. Of these patients, 1689 (7.8%) patients were identified as having an ASC during or prior to admission, with 598 patients meeting inclusion criteria. Changes in the allergy record were recommended by the ASC for 62% (n = 371) of patients; however, the allergy record was updated after the ASC in 74.9% (n = 278) of patients. CONCLUSION: ASC recommendations to delabel a patient as beta-lactam allergic must result in updating the allergy record in order to optimize future treatment. Given the low proportion of allergy-labeled patients tested, programs outside formal ASCs should be considered.
BACKGROUND: Many patients with a self-reported penicillin allergy go on to tolerate beta-lactam antibiotics. Allergy specialists may be consulted to determine the nature and extent of the allergy. However, electronic allergy records must be appropriately updated such that recommendations are carried forward. OBJECTIVE: To determine the percentage of patients who have their electronic allergy record updated after an allergy service consult (ASC). METHODS: This was a retrospective study of patients with at least 1 documented beta-lactam allergy and had an ASC during (inpatient) or prior to (outpatient) hospital admission at Northwestern Memorial Hospital and Prentice Women's Hospital in Chicago, Illinois. RESULTS: Within the study period, a total of 26 526 patients were identified as having a documented antibiotic allergy, with 21 657 patients (81.6% of patients with allergies) having a listed beta-lactam allergy. Of these patients, 1689 (7.8%) patients were identified as having an ASC during or prior to admission, with 598 patients meeting inclusion criteria. Changes in the allergy record were recommended by the ASC for 62% (n = 371) of patients; however, the allergy record was updated after the ASC in 74.9% (n = 278) of patients. CONCLUSION: ASC recommendations to delabel a patient as beta-lactam allergic must result in updating the allergy record in order to optimize future treatment. Given the low proportion of allergy-labeled patients tested, programs outside formal ASCs should be considered.
Entities:
Keywords:
allergy; allergy service consult; antibiotics; antimicrobial stewardship; beta-lactam
Authors: Gilbert Matte; Joseph Shuster; Chantal Guevremont; Phil Gold; Fabrice Leong; Zinquon Ngan; André Bonnici; Chris Tsoukas Journal: Can J Hosp Pharm Date: 2020-02-01