Pharmacy-driven penicillin allergy assessment offers multiple benefits

Rita Chamoun

A pharmacy-driven allergy assessment improved penicillin allergy documentation, increased the use of beta-lactam antibiotics and saved one hospital more than $21,000 over a 3-month period, according to prospective study findings that were presented at the American Society of Health-System Pharmacists Midyear Clinical Meeting and Exhibition.

“The findings of this research convey the importance of thoroughly evaluating allergy documentation on electronic health records as well as collaborating with pharmacists to evaluate for prior cephalosporin use,” Rita Chamoun, PharmD, BCPS, clinical staff pharmacist at the Baptist Hospital of Miami, told Healio Primary Care.

At the Baptist Hospital, researchers interviewed 63 patients to clarify their allergy history. They also evaluated the patients’ medication records and outpatient prescription fill history to assess their previous tolerance of beta-lactam antibiotics. For patients who had mild-to-moderate penicillin allergy and/or treatment with a beta-lactam antibiotic and patients with prior tolerance of beta-lactam antibiotics regardless of severity the researchers recommended treatment with a beta-lactam antibiotic to the prescriber.

According to Chamoun and colleagues, 68% of patients were switched from a non-beta-lactam antibiotic to a beta-lactam antibiotic, with a 100% prescriber acceptance rate. Prior beta-lactam use was confirmed in 57% of patients, allergy documentation was updated in 83% of patients and the clinic saved an estimated $21,468 over a 3-month period.

“Patients who report a penicillin allergy can very often be safely treated with a cephalosporin. Effective communication across the multidisciplinary team (prior to prescribing non-beta-lactam alternative antibiotics) is key to optimizing antibiotic therapy in these patients,” Chamoun told Healio Primary Care. – by Janel Miller

Reference: Chamoun R, et al. Improving penicillin allergy documentation and its effect on antibiotic prescribing at a community hospital. Presented at: American Society of Health-System Pharmacists Midyear Clinical Meeting and Exhibition; Dec. 8-12, 2019; Las Vegas.

Disclosure: Chamoun reports no relevant financial disclosures.