Song You-Chan, Nelson Zachary J, Wankum Michael A, Gens Krista D
Department of Pharmacy, Abbott Northwestern Hospital, Mail Route 11321, 800 East 28th Street, Minneapolis, MN 55407, USA.
Pharmacy (Basel). 2021 Jul 20;9(3):127. doi: 10.3390/pharmacy9030127.
Documented penicillin allergies have been associated with an increased risk of adverse outcomes. The goal of this project was to assess the effectiveness and feasibility of a pharmacist-led penicillin allergy "de-labeling" process that does not involve labor-intensive skin testing or direct oral challenges. Adult patients with penicillin allergies were identified and interviewed by an infectious diseases pharmacy resident during a 3-month pilot period. Using an evidence-based standardized checklist, the pharmacist determined if an allergy qualified for de-labeling. In total, 66 patients were interviewed during the pilot period. The average time spent was 5.2 min per patient interviewed. Twelve patients (18%) met the criteria for de-labeling and consented to the removal of the allergy. Four patients (6%) met the criteria but declined removal of the allergy. In brief, 58.3% of patients (7/12) who were de-labeled and 50% of patients (2/4) who declined de-labeling but had their allergy updated to reflect intolerance were subsequently prescribed beta-lactam antibiotics and all (9/9, 100%) were able to tolerate these agents. A pharmacist-led penicillin allergy de-labeling process utilizing a standardized checklist is an effective and feasible method for removing penicillin allergies in patients without a true allergy.
有记录表明，青霉素过敏与不良后果风险增加有关。本项目的目标是评估由药剂师主导的青霉素过敏“解除标签”流程的有效性和可行性，该流程不涉及劳动强度大的皮肤试验或直接口服激发试验。在为期3个月的试点期间，由一名传染病药学住院医师识别并采访对青霉素过敏的成年患者。药剂师使用基于证据的标准化检查表来确定过敏是否符合解除标签的条件。在试点期间，总共采访了66名患者。每位患者的平均采访时间为5.2分钟。12名患者（18%）符合解除标签的标准并同意去除过敏记录。4名患者（6%）符合标准但拒绝去除过敏记录。简而言之，解除标签的患者中有58.3%（7/12）以及拒绝解除标签但将过敏记录更新为不耐受的患者中有50%（2/4）随后被开具了β-内酰胺类抗生素，并且所有患者（9/9，100%）都能够耐受这些药物。由药剂师主导、利用标准化检查表的青霉素过敏解除标签流程是一种在没有真正过敏的患者中去除青霉素过敏记录的有效且可行的方法。
