Antibiotic reclamation: penicillin allergy, antibiotic stewardship, and the allergist

Abstract

During the past decade, interest, mounting evidence, and increasingly vigorous calls have all revolved around the issue of implementing antibiotic stewardship programs (ASPs). This movement crystallized into a formalized structure and approach with a policy statement jointly published by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society in 2012. [1] Fishman N. Patterson J. Saiman L. et al. Policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol. 2012; 33: 322-327 Crossref PubMed Scopus (463) Google Scholar This was followed by a recommendation issued in 2014 by the Centers for Disease Control and Prevention, urging hospitals in the United States to adopt ASPs. [2] Trivedi K.K. Dumartin C. Gilchrist M. Wade P. Howard P. Identifying best practices across three countries: hospital antimicrobial stewardship in the United Kingdom, France, and the United States. Clin Infect Dis. 2014; 59: S170-S178 Crossref PubMed Scopus (30) Google Scholar These developments mirror efforts across other nations to stem the continuing spread of antimicrobial resistance, a threat that has been further exacerbated by a dearth of novel antimicrobial agents in recent years. 2 Trivedi K.K. Dumartin C. Gilchrist M. Wade P. Howard P. Identifying best practices across three countries: hospital antimicrobial stewardship in the United Kingdom, France, and the United States. Clin Infect Dis. 2014; 59: S170-S178 Crossref PubMed Scopus (30) Google Scholar , 3 Bartlett J.G. A call to arms: the imperative for antimicrobial stewardship. Clin Infect Dis. 2011; 53: S4-S7 Crossref PubMed Scopus (95) Google Scholar The focus on the lack of new agents overlooks the untapped potential of reclaiming the use of first-line therapies, such as β-lactams, unavailable to some patients because of a documented or reported allergy.