Implementation of a Pharmacist-Driven Detailed Penicillin Allergy Interview

Area of Science:

• Clinical Pharmacy
• Infectious Diseases
• Patient Safety

Background:

• Self-reported penicillin allergies are often inaccurate, leading to suboptimal antimicrobial use.
• Penicillin skin testing is not universally available, necessitating alternative assessment methods.
• Detailed penicillin allergy interviews (DPAI) offer a feasible approach to refine allergy information.

Purpose of the Study:

• To evaluate the impact of a pharmacist-driven DPAI protocol on patient allergy profiles.
• To assess the rate of allergy profile updates and recommendations for beta-lactam therapy.
• To measure provider acceptance and patient tolerance of antimicrobial therapy changes.

Main Methods:

• Prospective, pharmacist-led DPAIs were conducted in adult patients with documented penicillin allergies.
• Electronic health records (EHR) were updated based on DPAI findings and a decision algorithm.
• Recommendations for non-carbapenem beta-lactam therapy were made when appropriate.

Main Results:

• 37.5% of patients underwent DPAI, with 76.0% having their allergy profile updated.
• Of patients on antimicrobials, 31.1% met criteria for switching to beta-lactam therapy.
• Successful transition to beta-lactam therapy occurred in 73.8% of eligible patients without intolerance.

Conclusions:

• Pharmacist-driven DPAIs effectively correct and update penicillin allergy information in EHRs.
• This process facilitates de-escalation and optimization of antimicrobial therapy.
• DPAIs improve patient safety and therapeutic outcomes by enabling appropriate beta-lactam use.