Background: Self-reported penicillin allergies may be outdated or inaccurate, leading to the use of alternative antimicrobials that may be less effective, more toxic, and/or more expensive.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.
机构:
Rutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USARutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USA
Andrews, L. B.
Bridgeman, M. B.
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机构:
Rutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USARutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USA
Bridgeman, M. B.
Dalal, K. S.
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机构:
Virtua Marlton, Dept Pharm, Marlton, NJ USARutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USA
Dalal, K. S.
Abazia, D.
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Rutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USARutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USA
Abazia, D.
Lau, C.
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Capital Hlth Med Ctr Hopewell, Dept Pharm, Hopewell, NJ USARutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USA
Lau, C.
Goldsmith, D. F.
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Capital Hlth Med Ctr Hopewell, Dept Pharm, Hopewell, NJ USARutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USA
Goldsmith, D. F.
St. John, D.
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机构:
Capital Hlth Med Ctr Hopewell, Dept Pharm, Hopewell, NJ USARutgers State Univ, Ernest Mario Sch Pharm, Dept Pharm Practice & Adm, Piscataway, NJ USA
机构:
Midwestern Univ, Coll Pharm, Dept Pharm Practice, Pharm Practice, Downers Grove, IL 60515 USA
Norwegian Amer Hosp, Wound Healing Ctr, Chicago, IL USAMidwestern Univ, Coll Pharm, Dept Pharm Practice, Pharm Practice, Downers Grove, IL 60515 USA
Rebolledo, Julio A.
Rhodes, Nathaniel J.
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Midwestern Univ, Coll Pharm, Dept Pharm Practice, Pharm Practice, Downers Grove, IL 60515 USA
Midwestern Univ, Pharmacometr Ctr Excellence, Downers Grove, IL 60515 USA
Northwestern Mem Hosp, Chicago, IL 60611 USAMidwestern Univ, Coll Pharm, Dept Pharm Practice, Pharm Practice, Downers Grove, IL 60515 USA
Rhodes, Nathaniel J.
Valdes, Angeles M.
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机构:
Humboldt Pk Hlth, Wound Healing Ctr, Chicago, IL USA
Norwegian Amer Hosp, Wound Healing Ctr, Dept Podiatry, Chicago, IL USAMidwestern Univ, Coll Pharm, Dept Pharm Practice, Pharm Practice, Downers Grove, IL 60515 USA
Valdes, Angeles M.
Kulekowskis, Annmarie
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Norwegian Amer Hosp, Wound Healing Ctr, Podiatr Med & Surg, Chicago, IL USAMidwestern Univ, Coll Pharm, Dept Pharm Practice, Pharm Practice, Downers Grove, IL 60515 USA
Kulekowskis, Annmarie
Kliethermes, Mary Ann
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Midwestern Univ, Dept Pharm Practice, Coll Pharm, Downers Grove, IL 60515 USAMidwestern Univ, Coll Pharm, Dept Pharm Practice, Pharm Practice, Downers Grove, IL 60515 USA