Improving antimicrobial stewardship by antibiotic allergy delabeling: Evaluation of knowledge, attitude, and practices throughout the emerging infections network

Antibiotic allergy testing (AAT) practices of Emerging Infections Network infectious disease physicians were surveyed. Although AAT was perceived to be necessary for removal of inappropriate or unnecessary allergy labels, there was limited access to any form of testing. In this study, we discuss current antibiotic allergy knowledge gaps and the development of AAT practices within antimicrobial stewardship programs, which will potentially improve antimicrobial prescribing

How antibiotic allergy labels may be harming our most vulnerable patients

Antibiotic allergy testing programs will ensure that vulnerable patients receive appropriate antibiotic therapy..

Beta-Lactam and sulfonamide allergy testing should be a standard of care in immunocompromised host

This work was supported by the Austin Medical Research Foundation. J.A.T. is supported by a National Health and Medical Research Council (NHMRC) postgraduate scholarship (GNT 1139902) and a postgraduate scholarship from the National Centre for Infections in Cancer, NHMRC, Centre for Research Excellence (App 1116876). E.J.P. receives grant support from the National Institutes of Health (award nos. 1P50GM115305-01) and the NHMRC

Antibiotic allergy testing improves antibiotic appropriateness in patients with cancer

Research lette

Antibiotic allergy De-Labeling: Teaching an old dog new tricks

Rationale Antibiotic allergy labels (AAL) significantly impact antibiotic prescribing and may lead to the inappropriate use of broad spectrum antibiotics which creates a public health concern. Infectious disease (ID) physicians from the Emerging Infections Network (EIN) of the Infectious Diseases Society of America (IDSA) were surveyed to determine their views, access and use of antibiotic allergy testing (AAT). Methods A 10-item online survey was distributed by the EIN in September 2015 to 1172 members practicing adult ID, 323 pediatric and 24 both. Two reminders were sent to non-respondents. Results Of 736/1,545 (48%), only 43% had skin prick/intradermal testing (SPT) available and 30% were either unaware of options or had none available. Although 78% overall suggested that a negative test would lead to AAL removal, those with > 15 years experience were significantly less likely to remove AAL (P<0.001). Most felt AAL removal would aid antibiotic selection (95%), appropriateness (92%), safety (74%) and antimicrobial-stewardship (AMS) (82%). Although 68% overall advocated incorporation of AAT into AMS, those with < 15 years experience were significantly more likely to support this (p=0.006). In settings of a remote reaction history, point-of-care testing (40%) was preferred to antibiotic desensitization (7%). Conclusions ID physicians perceive inadequate access to AAT services. Less experienced physicians were both more likely to view AAT as a means to remove AAL and advocate its incorporation into AMS. A generational shift appears to be occurring that should support AAT as a tool to improve antibiotic appropriateness

The 3 Cs of antibiotic allergy—classification, cross-reactivity, and collaboration

Antibiotic allergy labeling is highly prevalent and negatively impacts patient outcomes and antibiotic appropriateness. Reducing the prevalence and burden of antibiotic allergies requires the engagement of key stakeholders such as allergists, immunologists, pharmacists, and infectious diseases physicians. To help address this burden of antibiotic allergy overlabeling, we review 3 key antibiotic allergy domains: (1) antibiotic allergy classification, (2) antibiotic cross-reactivity, and (3) multidisciplinary collaboration. We review the available evidence and research gaps of currently used adverse drug reaction classification systems, antibiotic allergy cross-reactivity, and current and future models of antibiotic allergy care