Reported Knowledge and Management of Potential Penicillin Allergy in Children

Area of Science:

• Pediatric Allergy and Immunology
• Clinical Pediatrics
• Antibiotic Stewardship

Background:

• Pediatric emergency medicine (PEM) and primary care providers (PCPs) are key in diagnosing penicillin allergy in children.
• Existing research has not fully detailed knowledge and management differences regarding penicillin allergy between PEM and PCPs.

Purpose of the Study:

• To compare the knowledge and management practices of PEM and PCPs concerning reported penicillin allergy in children.
• To identify discrepancies in classifying penicillin allergy risk and in taking allergy histories.

Main Methods:

• A cross-sectional study involving a 20-question survey administered to PEM and PCPs.
• Statistical analysis (t tests, Chi-square, Wilcoxon tests) was used to compare knowledge of high- and low-risk symptoms and allergy history-taking extent.

Main Results:

• PEM and PCPs reported similar percentages of children with low-risk symptoms tolerating penicillin (74.1% and 69.0%, respectively).
• Both groups incorrectly identified common symptoms like vomiting and delayed rash as high-risk for penicillin allergy.
• PCPs conducted more detailed allergy histories than PEM providers, and both groups expressed interest in using allergy questionnaires.

Conclusions:

• Pediatric providers often acknowledge that children with remote low-risk allergy symptoms can tolerate penicillin, but this is not consistently applied in practice.
• A tendency exists for both PEM and PCPs to over-classify low-risk penicillin allergy symptoms as high-risk, leading to under-referral for allergy assessment.
• Both provider groups are open to decision support tools to improve penicillin allergy classification and promote appropriate antibiotic prescribing.