1001 Survey of maternity care providers to assess knowledge and management of penicillin allergy in pregnancy

Abstract

Penicillin allergy is commonly reported but only 10% are truly allergic. Reported penicillin allergy in pregnancy is associated with adverse maternal outcomes. Therefore, allergy evaluation should be considered during pregnancy. We sought to assess clinical practice patterns and baseline knowledge among maternity care providers to identify knowledge gaps. An anonymous electronic survey containing 23 questions assessing respondent characteristics, practice patterns, and antibiotic allergy knowledge was administered to all maternity care providers at a single tertiary hospital. Data were analyzed using descriptive statistics and bivariable analyses. 125 providers (29 attendings, 31 residents and fellows, 23 midwives and advance practice providers, and 42 nurses) responded. Respondent practice patterns and comfort with managing antibiotic allergies were assessed (Table 1). Most reported taking <2 minutes to assess allergy history. Only the minority always asked how long ago an allergic reaction occurred, asked if the patient received a similar antibiotic since the index reaction, or reported utilizing the medical record to determine what antibiotics were administered since. The distribution of knowledge responses are in Table 2. Most did not know the correct percentages of tolerance in reportedly allergic patients or the cross-reactivity between penicillins and cephalosporins. Most did not know that allergies can wane over time or how to test for an allergy. Physicians were significantly more likely to respond correctly compared to non-physicians, but years of experience was not significant. 54% (43/79) reported they never refer patients to an Allergy specialist, and the majority (53% (42/79) cited “limited knowledge” as their barrier. Significant knowledge gaps exist among maternity providers, which represent a missed opportunity to evaluate pregnant women with reported penicillin allergies. Educational interventions to improve provider knowledge would likely improve evaluation and referral of patients and positively impact pregnancy and maternal health outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)