Efficacy of a Pharmacy Resident-Driven Beta-Lactam Allergy Assessment at a Community Hospital

Abstract

Abstract Background Beta-lactams are the most commonly used antibiotics, although they are also associated with hypersensitivity reactions. Although approximately 10% of the population report an allergy to a beta-lactam, identifying erroneous beta-lactam allergies can lead to improved patient outcomes and lower rates of antimicrobial resistance. Methods This study was a single-center, retrospective review of a pharmacy resident driven beta-lactam allergy assessment. The allergy assessment consisted of a chart review and a 3-question interview. The primary outcome of this study was a composite of the following interventions: beta-lactam allergy delabeling, reaction specification, and/or identification of previously tolerated beta-lactams. Secondary outcomes included patients who were relabeled if delabeling occurred, patients who received beta-lactam therapy after changes occurred to their charted allergy, and impact on hospital utilization of beta-lactam alternative antibiotics. Results A total of 42 patients were interviewed between September 13, 2021, and December 17, 2021, with follow-up occurring 90 days after the initial interview. The most common beta-lactam allergy reported was penicillin (90.5%). Of the patients who were assessed, 95.2% met at least one of the components of the primary endpoint. Specifying the previous toleration of beta-lactam agents was the most common intervention, occurring after 78.6% of assessments. Complete delabeling of the patient's beta-lactam allergy occurred after 38.1% of the interviews conducted. Conclusions A pharmacy-resident driven beta-lactam allergy assessment was effective at clarifying beta-lactam allergies, including the complete delabeling of erroneous beta-lactam allergies.