A prospective observational study of the effect of penicillin skin testing on antibiotic use in the intensive care unit.
Infect Control Hosp Epidemiol
; 24(5): 347-50, 2003 May.
Article
em En
| MEDLINE
| ID: mdl-12785408
ABSTRACT
BACKGROUND:
Patients with penicillin allergy admitted to the intensive care unit (ICU) frequently receive non-beta-lactam antimicrobials for the treatment of infection. The use of these antimicrobials, more commonly vancomycin and fluoroquinolones, is associated with the emergence of multidrug-resistant infections. The penicillin skin test (PST) can help detect patients at risk of developing an immediate allergic reaction to penicillin and those patients with a negative PST may be able to use a penicillin antibiotic safely.METHODS:
We determined the incidence of true penicillin allergy, the percentage of patients changed to a beta-lactam antimicrobial when the test was negative, the safety of the test, and the safety of administration of beta-lactam antimicrobials in patients with a negative test. Skin testing was performed using standard methodology.RESULTS:
One hundred patients admitted to 4 ICUs were prospectively studied; 58 of them were male. The mean age was 63 years. Ninety-six patients had the PST one was positive (1.04%), 10 (10.4%) were nondiagnostic, and 85 (88.5%) were negative. Of the 38 patients who received antimicrobials for therapeutic reasons, 31(81.5%) had the antibiotic changed to a beta-lactam antimicrobial after a negative reading versus 7 patients of the 57 (12%) who had received a prophylactic antimicrobial (P < .001). No adverse effects were reported after the PST or after antimicrobial administration.CONCLUSIONS:
The PST is a safe, reliable, and effective strategy to reduce the use of non-beta-lactam antimicrobials in patients who are labeled as penicillin allergic and admitted to the ICU.
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Base de dados:
MEDLINE
Assunto principal:
Penicilinas
/
Testes Cutâneos
/
Hipersensibilidade a Drogas
/
Unidades de Terapia Intensiva
/
Antibacterianos
Idioma:
En
Ano de publicação:
2003
Tipo de documento:
Article