1794. Impact of a Pharmacist-Driven Detailed Penicillin Allergy Interview

BACKGROUND: In the United States, 10% of patients report a penicillin (PCN) allergy. These self-reported allergies may be outdated or inaccurate, which may lead to usage of alternate antimicrobials that may be less effective, more toxic, and/or more expensive. While PCN skin tests (PST) can provide an accurate assessment and de-labeling of PCN allergies, they are not feasible at all institutions. An alternative solution is to conduct a detailed penicillin allergy interview (DPAI), which can potentially lead to de-escalation and/or optimization of antimicrobial therapy. METHODS: Pharmacist-driven DPAIs were conducted between December 26, 2017 and March 26, 2018. Adult patients admitted with a documented PCN allergy were interviewed according to a standardized questionnaire. The allergy profile within the EHR was updated and a recommendation to switch to non-carbapenem β-lactam therapy was made to the prescriber based on a decision algorithm. Objectives of this study include characterization of changes made to the allergy profile within the EHR after DPAI and measuring the number of patients successfully switched to β-lactam therapy. RESULTS: A total of 466 patients were admitted with a documented PCN allergy, of which 175 (37.5%) received DPAI. Of these patients, 133 (76%) required a change to their allergy profile (Table 1). One-hundred thirty-five (77.1%) patients interviewed were on an antimicrobial agent (Figure 1). Forty-two patients (31.1%) met criteria to switch to non-carbapenem β-lactam therapy, and 31 (73.8%) patients were successfully switched with no adverse events noted. CONCLUSION: A large number of admitted patients with a documented PCN allergy received a DPAI. Implementation of pharmacist-driven DPAIs led to updated, more accurate allergy information within the EHR, as well as de-escalation and/or optimization of antimicrobial therapy. Provider acceptance rate to switch to non-carbapenem β-lactam therapy was high. DISCLOSURES: All authors: No reported disclosures.