Effect of a Drug Allergy Educational Program and Antibiotic Prescribing Guideline on Inpatient Clinical Providers' Antibiotic Prescribing Knowledge

被引：89

作者：

Blumenthal, Kimberly G. ^{[1
,2
]}

Shenoy, Erica S. ^{[2
,3
,4
]}

Hurwitz, Shelley ^{[5
]}

Varughese, Christy A. ^{[4
,6
]}

Hooper, David C. ^{[3
,4
]}

Banerji, Aleena ^{[1
]}

机构：

[1] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Div Rheumatol Allergy & Immunol,Dept Med, Boston, MA USA

[2] Massachusetts Gen Hosp, Med Practice Evaluat Ctr, Boston, MA 02114 USA

[3] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Div Infect Dis,Dept Med, Boston, MA USA

[4] Massachusetts Gen Hosp, Infect Control Unit, Boston, MA 02114 USA

[5] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USA

[6] Massachusetts Gen Hosp, Dept Pharm, Boston, MA 02114 USA

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE | 2014年 / 2卷 / 04期

关键词：

Drug; Antibiotic; Penicillin; Cephalosporin; Inpatient; Allergy; Hypersensitivity; Anaphylaxis; Immune-mediated; IgE mediated; Drug allergy; Antibiotic allergy; PENICILLIN ALLERGY; HISTORY; CARE; CEPHALOSPORINS; IMPACT;

D O I：

10.1016/j.jaip.2014.02.003

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

BACKGROUND: Inpatient providers have varying levels of knowledge in managing patients with drug and/or penicillin (PCN) allergy. OBJECTIVES: Our objectives were (1) to survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with PCN allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. METHODS: We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on drug allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin allergy. RESULTS: Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in drug allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P < .001) and loss of PCN allergy over time (54% vs 80%; P < .0001). Among those who reported attending an educational session (n = 62), preparedness to determine if an allergy was severe significantly improved (77% vs 92%; P = .03). Other areas, including understanding absolute contraindications to receiving a drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. CONCLUSIONS: Inpatient providers have drug allergy knowledge deficits but are interested in tools to help them care for inpatients with drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN allergy knowledge in several crucial areas. To improve care of inpatients with drug allergy, more research is needed to evaluate hospital policies and sustainable educational tools. (C) 2014 American Academy of Allergy, Asthma & Immunology

引用

页码：407 / 413

页数：7

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