Methods: This is a multi-center, retrospective study comparing aztreonam utilization in five hospitals within a healthcare system after implementation of a beta-lactam allergy assessment. The program included education as well as development of criteria for utilization and a beta-lactam allergy assessment algorithm. A beta-lactam allergy assessment was performed on any patient with an order for aztreonam. The Mann Whitney U test was used to assess the impact of the restriction program on aztreonam utilization and expenditure.
Results: The hospital system experienced roughly a 50% decrease in aztreonam days of therapy per 1000 patient days [p<0.01] and 67% reduction in annual expenditure [p<0.05]. Of the 204 patients with an order for aztreonam, 151 (74%) patients received at least one dose; however, 97 (48%) patients ultimately received and tolerated a beta-lactam. Only 112 (55%) patients had a prior reported reaction with 68 (61%) of those having a history of a Type I reaction.
Conclusion: Implementation of a beta-lactam allergy assessment for patients with reported allergies can enhance appropriate use of beta-lactams and result in reduced aztreonam utilization and expenditure.
T. Jaso, None
J. Bissett, None
M. T. Moser, None
A. L. V. Hobbs, None