The Application of Knowledge-Based Clinical Decision Support Systems to Detect Antibiotic Allergy

Area of Science:

• Clinical Informatics
• Pharmacovigilance
• Drug Allergy Prevention

Background:

• Patient safety is paramount, necessitating effective strategies for preventing drug allergies.
• Antibiotic allergies pose a significant risk, requiring robust detection and management systems.

Purpose of the Study:

• To evaluate the effectiveness of the K-CDS (Antibiotic Allergy-Checking Clinical Decision Support System).
• To assess the outcomes of implementing K-CDS in preventing antibiotic allergy-related adverse events.

Main Methods:

• Retrospective chart review across 29 hospitals.
• Analysis of 15,535 antibiotic allergy alert cases from 1,586 patients (May-August 2022).
• Evaluation of alert data, including antibiotic classes, cross-reactivity, and reported allergy symptoms.

Main Results:

• Cephalosporins were the most prescribed (48.5%).
• Higher cross-reactivity alerts were observed between beta-lactam antibiotics.
• Dermatological (38.8%) and gastrointestinal (28.4%) disorders were the most common symptoms; severe reactions like anaphylaxis (222 cases) and severe cutaneous adverse reactions (61 cases) were noted.

Conclusions:

• K-CDS effectively detects antibiotic allergies and prevents the prescription of potentially allergenic antibiotics.
• The system demonstrated success in managing patients with a history of antibiotic allergies.
• Nationwide expansion of cloud-based K-CDS could significantly reduce allergy recurrence from drug prescriptions.