Background: Penicillin allergy testing (PAT) can decrease the use of unnecessary antibiotics by clarifying who is truly allergic.
Objectives: This article describes the development and implementation of an oncology outpatient nurse-driven PAT program.
Methods: A nurse-driven program, initiated with allergy screening at the first encounter, was designed to identify patients with oncologic diagnoses eligible for PAT. Once verified eligible, patients undergo a three-step testing process (scratch test, intradermal injection, and IV challenge dose) administered by the infusion nurse.
Findings: From November 2018 to December 2019, 82 outpatients with reported penicillin allergies were screened; 90% were eligible for PAT, and 97% of patients tested were negative for penicillin allergy. A significant reduction in aztreonam use among patients admitted for hematopoietic stem cell transplantation was also noted as compared to before PAT was offered.
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http://dx.doi.org/10.1188/21.CJON.143-150 | DOI Listing |
J Allergy Clin Immunol Pract
January 2025
Novartis Pharmaceuticals, One Health Plaza, East Hanover, New Jersey, United States of America 07936. Electronic address:
Am J Emerg Med
January 2025
Department of Pharmacy, Sarasota Memorial Health Care System, 1700 S Tamiami Trail, Sarasota, FL 34239, USA.
Background: Patient-reported penicillin allergies are frequently encountered in the emergency department (ED), which often lead to non-beta-lactam antibiotic use despite beta-lactams' place as first-line therapy in most bacterial infections. The PEN-FAST clinical decision tool was developed and validated to identify patients with a low risk of true penicillin allergies that do not require formal skin testing for rechallenging. The tool consists of four questions that add up to a total score ranging from 0 to 5.
View Article and Find Full Text PDFAntibiotics (Basel)
January 2025
Department of Infectious Diseases, Sahlgrenska University Hospital, Region Västra Götaland, Diagnosvägen 21, SE-41650 Gothenburg, Sweden.
Background: Current antibiotic regimens for infective endocarditis (IE) are effective but pose a high risk of delayed hypersensitivity reactions (DHR). Dose adjustments guided by therapeutic drug monitoring (TDM) could mitigate these risks while maintaining treatment efficacy. This study aimed to investigate the plasma concentration of benzylpenicillin and cloxacillin in patients with IE and explore associations between antibiotic concentrations and DHR.
View Article and Find Full Text PDFClin Exp Allergy
January 2025
School of Infection, Inflammation and Immunology, University of Birmingham, Brimingham, UK.
Data regarding Penicillin allergy labels (PALs) from India and Sri Lanka are sparse. Emerging data suggests that the proportion of patients declaring an unverified PAL in secondary care in India and Sri Lanka (1%-4%) is lesser than that reported in High Income Countries (15%-20%). However, even this relatively small percentage translates into a large absolute number, as this part of the world accounts for approximately 25% of the global population.
View Article and Find Full Text PDFPediatr Qual Saf
January 2025
Division of Pediatric Surgery, Dayton Children's Hospital, Dayton, Ohio.
Introduction: A reported penicillin allergy reduces the likelihood that the patient will receive first-line surgical antibiotic prophylaxis (SAP), which can increase the risk of developing a surgical site infection (SSI). This project aimed to increase the use of first-line SAP agents in orthopedic and pediatric surgery patients with a reported penicillin allergy.
Methods: The Institute for Healthcare Improvement quality improvement methodology was followed.
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