What is it about?
Patients with penicillin allergy often receive inferior second line antibiotics for treatment of serious infections. How often they receive unnecessarily excessive antibiotics such as carbapenems is not as clearly defined.
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Why is it important?
This study found that patients with penicillin allergy were nearly four times more likely to receive carbapenems than those without penicillin allergy despite better overall prognosis and low risk of bloodstream infections due to ESBL-producing bacteria. Antimicrobial stewardship interventions (institutional management guidelines, allergy reconciliation, carbapenem prescription based on pre-approved indications, and post prescription audit with feedback) reduced carbapenem use without compromising patients' outcomes.
Perspectives
The study highlights the continued need for healthcare provider's education regarding the low cross-reactivity between penicillins and late-generation cephalosporins and the appropriate indications for carbapenems. Antimicrobial stewardship teams play an important role in this process and in modification of antibiotic prescription patterns for patients with penicillin allergy.
Prof. Majdi Al-Hasan
University of South Carolina School of Medicine
Read the Original
This page is a summary of: Impact of Penicillin Allergy on Empirical Carbapenem Use in Gram-Negative Bloodstream Infections: An Antimicrobial Stewardship Opportunity, Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy, December 2017, Wiley,
DOI: 10.1002/phar.2054.
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