1336. Beta-Lactam Allergy Record Updates after an Allergy Service Consult
Session: Poster Abstract Session: Clinical Practice Issues
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Allergy Consult_ID Week_10.19.16_FINAL.pdf (150.7 kB)
  • Background: To determine a true antibiotic allergy history, allergy services are often consulted as patient reported beta-lactam allergies poorly correlate with results from allergy testing. There is a lack of evidence regarding how often antibiotic allergy records are updated after an allergy service consult. The objective of this study was to evaluate the frequency of antibiotic allergies being correctly updated in the medical record after an allergy service consult.

    Methods: Patients considered for study inclusion were ≥18 years old, had an inpatient or outpatient allergy service consult, were hospitalized at Northwestern Memorial Hospital between January 2009-July 2012, and had at least one beta-lactam allergy listed in the medical record. Patients with an outpatient allergy service consult were required to have the allergy consult prior to hospitalization. Patient demographic, allergy consult, and antibiotic use information were collected.

    Results: A total of 156 patients were included in the study. Patients were predominantly female (n=84, 53.8%), Caucasian (n=104, 66.7%), with mean age 58.9 years (SD 17), median length of hospital stay 12 days (IQR 7-24.5), and median days to allergy service consult 5 (IQR 2-10). There were 90.4% of patients (n=141) with reported penicillin allergy, n=37, 23.7% with cephalosporin allergy, and n=9, 5.8% with reported allergy to carbapenems. A reaction was only documented in 75.6% of reported allergies with the most common reaction being rash/itching (n=57, 46.7%). The allergy service recommended changes in 71.6% (n=111) of cases. The allergy list was updated post allergy service consult for 73.9% (n=82) of patients. Allergy service recommendations were followed 98.1% of the time and antibiotics were changed post allergy consult in 81.4% of cases. The median length of antibiotic therapy was 18 days (IQR 10.5-30.5).

    Conclusion: Approximately 30% of medical records were not updated after an allergy service consult recommended changes to the allergy record. These patients are at risk for receiving less efficient and more costly antibiotics. Future studies should focus on the development of a stewardship intervention post allergy consult.

    Bryan G. Shaw, PharmD1, Michael G. Ison, MD, FIDSA2, Elise M. Gilbert, PharmD1,3, Viktorija O. Barr, PharmD1,4, Inela Masic, BS5, Nancy Gorgi, PharmD Candidate5, Niree Kalfayan, BS5 and Milena M. Mclaughlin, PharmD, MSc1,5, (1)Northwestern Memorial Hospital, Chicago, IL, (2)Northwestern Univ. Sch. of Med., Chicago, IL, (3)College of Pharmacy, Chicago State University, Chicago, IL, (4)Rosalind Franklin University College of Pharmacy, North Chicago, IL, (5)Midwestern University Chicago College of Pharmacy, Downers Grove, IL

    Disclosures:

    B. G. Shaw, None

    M. G. Ison, None

    E. M. Gilbert, None

    V. O. Barr, None

    I. Masic, None

    N. Gorgi, None

    N. Kalfayan, None

    M. M. Mclaughlin, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.