Pharmacists Investigating Adverse Penicillin Responses—Pilot Study

Abstract

ABSTRACTBackgroundPenicillins are used first‐line for many infections and are commonly associated with adverse drug responses. Pharmacists can take a detailed adverse drug response history and provide such information to prescribers.AimTo investigate and quantify the nature of adverse penicillin responses of hospital inpatients and to develop a tool to enable pharmacists to provide recommendations on potential rechallenge of patients with a history of adverse response to penicillin.MethodPatients were administered a structured interview to classify the true nature of their documented adverse penicillin responses. A literature review was undertaken to develop a flowchart to enable pharmacists to advise on penicillin rechallenge in patients with a history of adverse response to penicillin.Results84 patients were identified and 49 (58%) met the inclusion criteria. Of these 18% had either a true penicillin allergy or were not able to recall the nature of their reaction. Of the 49 patients interviewed, 82% could be rechallenged with a penicillin. The literature review identified publications that allowed the development of a flowchart to assist pharmacists in evaluating reactions and recommending future therapy for these patients.ConclusionIn this small cohort, a significant proportion of patients were considered appropriate for rechallenge with penicillins. Knowledge of the sequelae of previous exposure to penicillins can inform decisions should a penicillin be indicated for treatment. The flowchart will allow pharmacists to make recommendations to the patient's medical team.