A Survey of Current Physician Practice and Knowledge of Drug Allergy at a University Medical Center

Abstract

Physicians are challenged with drug allergy (DA) on a regular basis. This study was performed to determine current knowledge and practice patterns regarding DA at our center. A survey was emailed to all faculty and resident physicians at a university medical center on their management of patients with DA, knowledge of DA, and clinical indications for skin testing (ST) and desensitization. 231 of 986 surveys were completed using SurveyMonkey®. The average percent of patients seen by respondents reporting any DA was 32.2%. Respondents thought only 30.5% of patients reporting DA would react if given the suspected drug; however, only 15% would give the drug. 49% reported previously performing or ordering a consult for drug desensitization. Of the 25 knowledge questions on DA, the average score for the cohort was 16.65 correct (66.6%). Urticaria with penicillin was the most frequent correct answer as a clinical indication for ST (83.5%) and desensitization (69.3%); however, only 43.7% and 46.7% of respondents cited anaphylaxis with piperacillin as an indication for ST and desensitization, respectively. 15.6% of respondents recognized that desensitization could be performed for AERD. Although no significant differences were found regarding DA knowledge between attendings and residents, or primary care physicians and specialists, physicians with any Internal Medicine training did score significantly higher than those without such training (average correct, 17.3 vs. 16.3, p<0.01). Physician's knowledge of DA was worse than expected and could adversely affect quality of patient care. Further research should focus on outcomes of patients with drug allergies.