Collaboration between allergists and pharmacists increases β-lactam antibiotic prescriptions in patients with a history of penicillin allergy

Miguel Park, Brad J. McClimon, Brent Ferguson, Patricia J. Markus, Laura Odell, Andrea Swanson, Kristin E. Kloos-Olson, Peter F. Bjerke, James T. Li

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Over 90% of patients with a history of penicillin allergy have negative penicillin skin tests. Pharmacists are trained to identify and resolve medication-related problems. We hypothesized that collaboration between allergists and pharmacists to identify and evaluate patients with a history of penicillin allergy would increase β-lactam antibiotic prescription. Methods: We conducted a prospective observational study in which patients with a history of penicillin allergy were identified and educated at the pharmacy about penicillin allergy and offered an allergist consultation with a penicillin skin test. All patients were followed up to determine which antibiotics were subsequently prescribed. Results: A total of 503 patients were enrolled, and 71 (14%) were evaluated by an allergist. Sixty-seven of these 71 patients (94%) had a negative penicillin skin test. Twenty-nine patients evaluated by an allergist and 205 patients not evaluated were prescribed antibiotics. Patients prescribed antibiotics and evaluated by an allergist were compared to those not evaluated by an allergist, with the following results: 19 of 29 patients (66%) were prescribed a β-lactam antibiotic compared to 54 of 205 (26%; p < 0.0001); 8 of 29 patients (28%) were prescribed penicillin compared to 7 of 205 (3%; p < 0.0001); 15 of 29 patients (52%) were prescribed a cephalosporin compared to 48 of 205 (23%; p < 0.01), and 10 of 29 patients (34%) were prescribed a non-β-lactam antibiotic compared with 177 of 205 (86%; p < 0.0001). Conclusion: A collaborative effort between allergists and pharmacists can increase β-lactam antibiotic prescriptions and decrease non-β-lactam prescriptions in patients with a history of penicillin allergy.

Original languageEnglish (US)
Pages (from-to)57-62
Number of pages6
JournalInternational Archives of Allergy and Immunology
Volume154
Issue number1
DOIs
StatePublished - Dec 1 2010

Fingerprint

Lactams
Pharmacists
Penicillins
Prescriptions
Hypersensitivity
Anti-Bacterial Agents
Skin Tests
Allergists
Cephalosporins

Keywords

  • β-Lactam antibiotic
  • Allergist
  • Antibiotics
  • Penicillin
  • Penicillin allergy
  • Pharmacist

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Collaboration between allergists and pharmacists increases β-lactam antibiotic prescriptions in patients with a history of penicillin allergy. / Park, Miguel; McClimon, Brad J.; Ferguson, Brent; Markus, Patricia J.; Odell, Laura; Swanson, Andrea; Kloos-Olson, Kristin E.; Bjerke, Peter F.; Li, James T.

In: International Archives of Allergy and Immunology, Vol. 154, No. 1, 01.12.2010, p. 57-62.

Research output: Contribution to journalArticle

Park, Miguel ; McClimon, Brad J. ; Ferguson, Brent ; Markus, Patricia J. ; Odell, Laura ; Swanson, Andrea ; Kloos-Olson, Kristin E. ; Bjerke, Peter F. ; Li, James T. / Collaboration between allergists and pharmacists increases β-lactam antibiotic prescriptions in patients with a history of penicillin allergy. In: International Archives of Allergy and Immunology. 2010 ; Vol. 154, No. 1. pp. 57-62.
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abstract = "Background: Over 90{\%} of patients with a history of penicillin allergy have negative penicillin skin tests. Pharmacists are trained to identify and resolve medication-related problems. We hypothesized that collaboration between allergists and pharmacists to identify and evaluate patients with a history of penicillin allergy would increase β-lactam antibiotic prescription. Methods: We conducted a prospective observational study in which patients with a history of penicillin allergy were identified and educated at the pharmacy about penicillin allergy and offered an allergist consultation with a penicillin skin test. All patients were followed up to determine which antibiotics were subsequently prescribed. Results: A total of 503 patients were enrolled, and 71 (14{\%}) were evaluated by an allergist. Sixty-seven of these 71 patients (94{\%}) had a negative penicillin skin test. Twenty-nine patients evaluated by an allergist and 205 patients not evaluated were prescribed antibiotics. Patients prescribed antibiotics and evaluated by an allergist were compared to those not evaluated by an allergist, with the following results: 19 of 29 patients (66{\%}) were prescribed a β-lactam antibiotic compared to 54 of 205 (26{\%}; p < 0.0001); 8 of 29 patients (28{\%}) were prescribed penicillin compared to 7 of 205 (3{\%}; p < 0.0001); 15 of 29 patients (52{\%}) were prescribed a cephalosporin compared to 48 of 205 (23{\%}; p < 0.01), and 10 of 29 patients (34{\%}) were prescribed a non-β-lactam antibiotic compared with 177 of 205 (86{\%}; p < 0.0001). Conclusion: A collaborative effort between allergists and pharmacists can increase β-lactam antibiotic prescriptions and decrease non-β-lactam prescriptions in patients with a history of penicillin allergy.",
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AB - Background: Over 90% of patients with a history of penicillin allergy have negative penicillin skin tests. Pharmacists are trained to identify and resolve medication-related problems. We hypothesized that collaboration between allergists and pharmacists to identify and evaluate patients with a history of penicillin allergy would increase β-lactam antibiotic prescription. Methods: We conducted a prospective observational study in which patients with a history of penicillin allergy were identified and educated at the pharmacy about penicillin allergy and offered an allergist consultation with a penicillin skin test. All patients were followed up to determine which antibiotics were subsequently prescribed. Results: A total of 503 patients were enrolled, and 71 (14%) were evaluated by an allergist. Sixty-seven of these 71 patients (94%) had a negative penicillin skin test. Twenty-nine patients evaluated by an allergist and 205 patients not evaluated were prescribed antibiotics. Patients prescribed antibiotics and evaluated by an allergist were compared to those not evaluated by an allergist, with the following results: 19 of 29 patients (66%) were prescribed a β-lactam antibiotic compared to 54 of 205 (26%; p < 0.0001); 8 of 29 patients (28%) were prescribed penicillin compared to 7 of 205 (3%; p < 0.0001); 15 of 29 patients (52%) were prescribed a cephalosporin compared to 48 of 205 (23%; p < 0.01), and 10 of 29 patients (34%) were prescribed a non-β-lactam antibiotic compared with 177 of 205 (86%; p < 0.0001). Conclusion: A collaborative effort between allergists and pharmacists can increase β-lactam antibiotic prescriptions and decrease non-β-lactam prescriptions in patients with a history of penicillin allergy.

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