New Hospital Guidelines: Assess Penicillin Allergy To Ensure Optimal Antibiotic Use

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Jun 22, 2016, 08:07 ET

ROUND ROCK, Texas, June 22, 2016 /PRNewswire/ -- Every hospital should consider screening patients for penicillin allergy as a basic strategy to stop antibiotic misuse and over-prescribing, according to a new playbook for America's acute care hospitals.

Recent studies show that only a tiny fraction of people – less than 1 percent of the entire U.S. population – is truly allergic to penicillin.¹ This is significant, since penicillin antibiotics are often the safest, least expensive treatment option. Americans who report being penicillin-allergic frequently receive more toxic, broad spectrum antibiotics that can lead to drug-resistant "super bug" infections – an increasing global health threat.²

Hospitals should "establish guidance for antibiotic allergy assessment (e.g., a penicillin allergy assessment protocol, including recommendations on which patients might benefit from skin testing)," states the new "Antibiotic Stewardship in Acute Care: A Practical Playbook."

The playbook was developed by the U.S. Centers for Disease Control and Prevention (CDC), in collaboration with the National Quality Forum (NQF), Hospital Corporation of America (HCA) and dozens of professional societies.

"Penicillin is the most commonly reported drug allergy. Although approximately 10-20% of patients report a history of penicillin allergy, up to 90% of these individuals are in fact able to tolerate penicillin and penicillin-like antibiotics," says Mary L. Staicu, Pharm.D., Infectious Diseases Clinical Pharmacy Specialist for Rochester Regional Health (RRH) in New York.

A false penicillin allergy can have serious clinical and financial repercussions, Staicu adds. "These include exposure to alternative antibiotics which may be more expensive and less effective; increased prevalence of resistant bacterial infections such as methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and C. difficile; and longer hospital stays," she says.

An estimated 30 to 50 percent of antibiotics prescribed in U.S. hospitals are "unnecessary or inappropriate," according to the CDC.³ Ruling out a penicillin allergy may curb rates of infections such as C. difficile – a bacterium that causes diarrhea and kills at least 14,000 hospital patients annually.⁴

"Investment in antibiotic stewardship programs has demonstrated improved patient outcomes, reduced antibiotic resistance, lives saved, and reduced healthcare costs," the CDC notes in the new playbook. "Hospital leaders play a critical role in ensuring that staff prescribe antibiotics only in cases where they can improve health outcomes."

For more information on penicillin skin testing visit http://www.prepen.com/.

1, 2, Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol. 2010 Oct;105(4):259‐273.

3 CDC Get Smart Campaign

4 CDC Antibiotic / Antimicrobial Resistance

SOURCE PRE-PEN