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药师主导的青霉素过敏去标签方案对重症监护病房报告的过敏率的影响。

Impact of a Pharmacist Driven Penicillin Allergy De-labeling Protocol on Rates of Reported Allergy in the Intensive Care Unit.

作者信息

Mahmud Mujtaba, Kokoy Shahristan R, Stollings Joanna L, McCoy Allison B, Koo Grace, Dear Mary Lynn, Rice Todd W, Phillips Elizabeth J, Stone Cosby A

机构信息

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA.

Vanderbilt University Medical Center, Nashville, TN, USA.

出版信息

Hosp Pharm. 2025 May 6:00185787251337625. doi: 10.1177/00185787251337625.

Abstract

Inaccurate penicillin allergy labels (PALs) results in use of broader, less optimized antibiotics. Studies have shown challenging low-risk PALs is safe and effective. We assessed the proportion of PALs among critically ill patients after a pharmacist driven allergy de-labeling program was implemented in the medical intensive care unit (MICU) between November 2017 and March 2023. There was a notable reduction in the proportion of PALs pre-intervention (14.0%) and post-intervention (12.8%). Persistent reductions in the proportion of PALs among readmitted patients was seen in both MICU (21.4% to 15.9%) and non-MICU patients (13.8% to 11.1%). This study further emphasizes the potential for proactive surveillance and intervention on low-risk PALs by pharmacists to reduce the burden of broad-spectrum antibiotics, which may optimize antibiotic usage and possibly impact institutional antimicrobial spectrum.

摘要

不准确的青霉素过敏标签(PALs)会导致使用更广泛、优化程度更低的抗生素。研究表明,对低风险PALs提出质疑是安全有效的。我们评估了2017年11月至2023年3月期间在医疗重症监护病房(MICU)实施药剂师驱动的过敏标签去除计划后,重症患者中PALs的比例。干预前(14.0%)和干预后(12.8%)PALs的比例有显著下降。在MICU(从21.4%降至15.9%)和非MICU患者(从13.8%降至11.1%)中,再次入院患者的PALs比例持续下降。这项研究进一步强调了药剂师对低风险PALs进行主动监测和干预以减轻广谱抗生素负担的潜力,这可能会优化抗生素的使用,并可能影响机构的抗菌谱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55fd/12055799/647ca49d67ff/10.1177_00185787251337625-fig1.jpg

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