Beta-lactam antibiotic test doses in the emergency department
| Autor: | Erica S. Shenoy, Sarah Bor, Ramy H. Elshaboury, Bryan D. Hayes, Michelle Maguire, Anna R. Wolfson, Ronak G Gandhi, Christian M. Mancini, Kimberly G. Blumenthal, Lanting Fuh |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
lcsh:Immunologic diseases. Allergy medicine.medical_specialty Allergy medicine.drug_class Immunology Cephalosporin Acute Article 03 medical and health sciences 0302 clinical medicine EHR electronic health record Internal medicine Acute care Hypersensitivity medicine polycyclic compounds Immunology and Allergy Challenge 030223 otorhinolaryngology business.industry Public health Beta lactam antibiotic Guideline Emergency department biochemical phenomena metabolism and nutrition Penicillin medicine.disease HSR hypersensitivity reaction 3. Good health CI confidence interval 030228 respiratory system ED emergency department business lcsh:RC581-607 PST penicillin skin testing medicine.drug |
| Zdroj: | World Allergy Organization Journal, Vol 13, Iss 1, Pp-(2020) The World Allergy Organization Journal |
| ISSN: | 1939-4551 |
| Popis: | Background: Facilitating beta-lactam antibiotic use in patients reporting beta-lactam allergies in acute care settings is important to individual patient outcomes and public health; however, few initiatives have targeted the Emergency Department (ED) setting. Methods: We implemented pathways for patients reporting prior penicillin and/or cephalosporin hypersensitivity as part of a hospital guideline in the ED of a large academic medical center in the United States. We described beta-lactam test doses, pathway compliance, hypersensitivity reactions (HSRs), and allergy record updating associated with ED-administered beta-lactam test doses from October 2016 to June 2018. Results: 310 beta-lactam antibiotic test doses were administered to patients with penicillin and/or cephalosporin allergy histories in the study period (average volume 15/month [standard deviation 4]). Test doses were to cephalosporins (85%), penicillins (12%), and carbapenems (4%). 219 (71%) of test doses were compliant with the pathways. Ten patients (3.2%; 95% CI 1.6%–5.9%) had HSRs; five HSR patients (50%) had beta-lactams administered that were not pathway compliant. The allergy record was updated in 146 (47%) of patients, with improvement over the study period (p |
| Databáze: | OpenAIRE |
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