SHM Converge Scientific Abstract ePoster Gallery-An Intervention Addressing Overuse of Broad-Spectrum Antibiotics for Penicillin Allergies

Pdf Summary

This study examined antibiotic prescribing patterns for patients with documented penicillin (PCN) allergies and found that such patients were more likely to receive non-beta-lactam antibiotics (NBLs) than patients without a PCN allergy. Among PCN-allergic patients who received antibiotics, 39.9% were prescribed NBLs, including quinolones (14.4%) and aminoglycosides (12.8%). In contrast, about 20% of patients without a PCN allergy received NBLs.<br /><br />A key finding was that aminoglycosides were significantly more likely to be used in patients with a documented PCN allergy: 1.83 times more likely overall, and still 1.58 times more likely even after excluding patients whose allergy history included anaphylaxis. This suggests that antibiotic choice is influenced by the presence of a penicillin allergy label, even when the allergy may not represent a high-risk reaction.<br /><br />The study also identified problems with allergy history documentation. Allergy information was often incomplete, and “unknown” reaction types were commonly documented. Clinician interviews suggested that residents often view NBLs as the safer option and rarely manually check prior beta-lactam use because of time constraints and difficulty navigating the electronic medical record.<br /><br />Overall, the authors conclude that patients with non-IgE-mediated PCN allergies are more likely to receive NBLs, potentially unnecessarily. These findings will help guide a quality improvement intervention aimed at reducing NBL prescribing in patients with low-risk penicillin allergies.

Asset Subtitle

Bryana Banashefski

Meta Tag

Author List Anne S. Linker, Bryana Banashefski, Frans J. Beerkens, Hui Ting Kok, Margaret Shyu, Navindra David, Phil Henson, Risa Fuller, Surafel Tsega

Category Research

Concept Penicillin Allergy

Concept Beta-Lactam Antibiotics

Concept Non-Beta-Lactam Antibiotic

Concept Antibiotic Prescribing Pattern

Concept Non-IgE-Mediated Allergy

Distinguished Non-Finalist

Presenter Organization Icahn School of Medicine at Mount Sinai

Presenting Author Bryana Banashefski

Track Quality Improvement

Keywords

penicillin allergy

antibiotic prescribing

non-beta-lactam antibiotics

aminoglycosides

quinolones

allergy documentation

beta-lactam use

electronic medical record

quality improvement

low-risk allergy

Penicillin Allergy

Beta-Lactam Antibiotics

Non-Beta-Lactam Antibiotic

Antibiotic Prescribing Pattern

Non-IgE-Mediated Allergy