AAAAI 2023: Penicillin De-Labeling Protocol Effective in Helping Patients Remember Their Nonallergic Status
However, findings show that pharmacies often keep penicillin allergy on record
MONDAY, March 6, 2023 (HealthDay News) – A penicillin de-labeling protocol was successful in maintaining nonallergic status and allowing penicillin prescription for patients, but barriers still exist in in de-labeling patients as penicillin-allergic, according to findings presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology, held from Feb. 24 to 27 in San Antonio.
“Patients who carry a penicillin allergy label are associated with increased health care costs and adverse events,” Althea Marie Diaz, M.D., of NYU Langone Long Island Hospital, told Elsevier’s PracticeUpdate. “De-labeling a penicillin allergy can optimize antimicrobial stewardship and improve patient care.”
Diaz and colleagues conducted a retrospective study of patients who were de-labeled of a penicillin allergy after negative skin testing and aminopenicillin oral challenge. The allergy was removed from the electronic medical record (EMR) and patients received a wallet card with the results. The researchers later conducted EMR review and phone interviews with patients and pharmacies to determine penicillin allergy status and patterns of antibiotic prescribing.
Of 78 reviewed charts, 99 percent remained de-labeled in the EMR, but 31 percent still had an active penicillin allergy listed in their pharmacy records. Of 68 patients who underwent interviews, 97 percent remembered their negative penicillin allergy result and 44 percent took penicillins since they were de-labeled. However, 46 percent were not prescribed penicillins and 6 percent still avoided penicillins.
“Our study demonstrates that our penicillin de-labeling protocol is effective for patients to recall that they are not penicillin allergic,” Diaz told Elsevier’s PracticeUpdate. “However, the discrepancy in allergic status between our EMR and patients’ pharmacies exemplifies the need to identify barriers in universally de-labeling patients. We suspect that further obstacles may exist in prescribing patterns from primary physicians, but further studies are needed.”
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