Inpatient Clinicians Show Limited Understanding of PCN Allergy
About half of respondents were unfamiliar with cross-reactivity rates for penicillin, other antibiotics
WEDNESDAY, June 14, 2017 (HealthDay News) -- Inpatient hospital practitioners often have a limited understanding of the management of patients with a history of penicillin allergy, according to a study published online June 13 in the Annals of Allergy, Asthma & Immunology.
Mary L. Staicu, Pharm.D., from Rochester General Hospital in New York, and colleagues distributed an electronic survey to attending physicians, residents, pharmacists, nurse practitioners, and physician assistants practicing adult inpatient medicine. Completed surveys were analyzed from 276 practitioners.
Most of the respondents were attending physicians (45 percent) with more than 10 years of experience (53 percent). The researchers found that about half the respondents were unfamiliar with the cross-reactivity rates between penicillin and cephalosporin, carbapenem, and monobactam antibiotics (46, 42, and 48 percent, respectively). Only 41 and 19 percent of respondents appropriately considered penicillin skin testing and temporary induction of drug tolerance as the leading antibiotic management plans, respectively, in case vignettes. In clinical scenarios, respondents acknowledged the need for allergy/immunology consultation, but 86 percent reported that they never consult an allergist or immunologist, or do so only once a year. Pharmacists had a better understanding of penicillin allergy and antibiotic cross-reactivity overall (P < 0.05).
"There is an overall limited understanding of the management of patients with a history of penicillin allergy in the hospital setting, where collaborative efforts between allergy and nonallergy health care practitioners are sparse," the authors write.