Implementation of a Pharmacist-Driven Detailed Penicillin Allergy Interview

被引:14
|
作者
Mann, Katrina L. [1 ]
Wu, Janet Y. [1 ]
Shah, Sneha S. [1 ]
机构
[1] Cleveland Clin, 9500 Euclid Ave,Hb 105, Cleveland, OH 44195 USA
关键词
penicillin allergy; beta-lactam; antimicrobial; carbapenem; allergy interview; HOSPITALIZED-PATIENTS; PREVALENCE;
D O I
10.1177/1060028019884874
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Background: Self-reported penicillin allergies may be outdated or inaccurate, leading to the use of alternative antimicrobials that may be less effective, more toxic, and/or more expensive. Although penicillin skin tests can provide accurate assessments of penicillin allergies, these procedures are not feasible at all institutions. Another solution is to conduct a detailed penicillin allergy interview (DPAI), which can potentially lead to optimization of antimicrobial therapy. Objective: The purpose of this study was to assess the impact of a pharmacist-driven DPAI protocol. The primary objective was to measure the number of patients requiring a change to their allergy profile following DPAI. Secondary objectives included characterizing allergy profile updates and measuring the number of recommendations to switch to a beta-lactam agent, provider acceptance rate, and patient tolerance. Methods: Standardized pharmacist-driven DPAIs were conducted prospectively on adult patients admitted with a documented penicillin allergy. The allergy profile within the electronic health record (EHR) was updated and a recommendation to switch to noncarbapenem beta-lactam therapy was made when indicated by a decision algorithm. Results: A total of 175 (37.5%) patients received a DPAI. Of these, 133 (76.0%) required a change to their allergy profile. Additionally, 135 (77.1%) patients interviewed were on antimicrobial therapy, with 42 (31.1%) meeting criteria to switch to noncarbapenem beta-lactam therapy; of which 31 (73.8%) patients were successfully transitioned, with no signs or symptoms of intolerance. Conclusions and Relevance: Implementation of pharmacist-driven DPAIs can provide updated and corrected allergy information within the EHR, allowing for de-escalation and/or optimization of antimicrobial therapy.
引用
收藏
页码:364 / 370
页数:7
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