Residents and Fellows Research in Progress
Monday, November 13, 2023
01:00 PM–02:30 PM
Abstract
Introduction: About 20% of hospitalized patients report a penicillin allergy; however, fewer than 5% of these patients are truly allergic to penicillins. These falsely labeled penicillin allergies contribute to negative health and cost outcomes such as increased mortality, prolonged length of hospitalization, and extended duration of antibiotic therapy. Additionally, they negatively impact antimicrobial stewardship, fostering the development of antibiotic-resistant infections. PEN-FAST is an internationally validated scoring system used to determine one’s risk of having a positive reaction to a penicillin allergy test. This simple, four-question assessment may enable the healthcare team to efficiently de-label patients with inaccurately reported penicillin allergies, thus allowing for more appropriate utilization of antibiotic therapies.
Research Question or Hypothesis: Does the implementation of a low-dose amoxicillin challenge protocol provide a safe and effective process for removing inaccurate penicillin allergies from the medical record and improve antibiotic prescribing in a hospital setting?
Study Design: Single-center, prospective quality-improvement project.
Methods: A PEN-FAST score will be completed on all admitted adult patients who have a listed penicillin allergy, are prescribed antibiotics, and are able to take medications via the enteral route. Those with a PEN-FAST score less than three will consent to receive a one-time dose of amoxicillin 250 mg. If no adverse reactions are noted within 60 minutes, the penicillin allergy will be removed from their chart and, if needed, antibiotic therapy will be optimized. The primary study outcome is the proportion of patients whose penicillin allergy was removed from their medical charts. Secondary outcomes include incidence of adverse events and the proportion of patients whose therapy was either changed to a ß-lactam or deescalated to a narrower-spectrum ß-lactam within 24 hours of the amoxicillin challenge. Outcomes will include all those who had a PEN-FAST score completed and will be stratified by participation vs. non-participation in the low-dose amoxicillin challenge.
Results: Pending.
Conclusion: Pending.
Presenting Author
J. Andrew Hopkins PharmDEastern Idaho Regional Medical Center
Authors
Erin Berry PharmD, BCPS
Eastern Idaho Regional Medical Center
Eliza Borzadek BSN, PharmD, BCPS
Eastern Idaho Regional Medical Center
Rachel Lopez PharmD, BCPS
Eastern Idaho Regional Medical Center
Eric Sievers PharmD, BCPS
Eastern Idaho Regional Medical Center