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
Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA.
Vanderbilt University Medical Center, Nashville, TN, USA.
Hosp Pharm. 2025 May 6:00185787251337625. doi: 10.1177/00185787251337625.
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.
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。