Impact of ß-Lactam Allergies on Antimicrobial Selection in an Outpatient Setting.
South Med J
; 112(11): 591-597, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31682741
ABSTRACT
OBJECTIVE:
The primary objective of this study was to determine whether patients prescribed nonpreferred antibiotics received appropriate alternative antibiotics.METHODS:
This was a retrospective observational analysis of military veteran patients with a ß-lactam allergy treated in an outpatient clinic or emergency department for an infection during a 5-year span. Antibiotic regimens were first stratified as preferred or nonpreferred based on infection-specific guidelines. The nonpreferred regimens were then evaluated for appropriateness based on allergy history and culture and sensitivity reports.RESULTS:
Of 445 fills of antibiotics evaluated, 269 met inclusion criteria, comprising 253 unique infections in 80 patients. Patients received nonpreferred antibiotics for their infection type in 57% of cases. Of the nonpreferred antibiotics, 56% were inappropriate based on guideline-recommended alternatives, allergy history, and culture and sensitivity data. Of the 88 allergies, 97% were historical/self-reported and 48% were cutaneous. In addition, 39% of patients safely received ß-lactam antibiotics after documentation of their allergy.CONCLUSIONS:
Patients with documented ß-lactam allergies are at high risk of receiving nonpreferred and inappropriate antibiotics, and many reactions likely do not reflect true allergies. These data emphasize the negative impact of the "ß-lactam allergy" label and the importance of reassessing allergies.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Prescrições de Medicamentos
/
Beta-Lactamas
/
Hipersensibilidade a Drogas
/
Prescrição Inadequada
/
Antibacterianos
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article