Cargando…

P38 Audit and reaudit of penicillin allergy documentation in patients presenting through the Emergency Department at the Royal Berkshire Hospital

BACKGROUND: Penicillin allergy is the commonest reported drug allergy in the UK. However, it is estimated that under 10% are true allergies. Evidence shows that using second-line antibiotics is associated with worse clinical outcomes, greater healthcare costs and increased risk of antimicrobial resi...

Descripción completa

Detalles Bibliográficos
Autores principales: Shenoy, Aniruddh, Malakouti, Afsaneh, Iyer, Shabnam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849403/
http://dx.doi.org/10.1093/jacamr/dlac004.037
_version_ 1784652457826058240
author Shenoy, Aniruddh
Malakouti, Afsaneh
Iyer, Shabnam
author_facet Shenoy, Aniruddh
Malakouti, Afsaneh
Iyer, Shabnam
author_sort Shenoy, Aniruddh
collection PubMed
description BACKGROUND: Penicillin allergy is the commonest reported drug allergy in the UK. However, it is estimated that under 10% are true allergies. Evidence shows that using second-line antibiotics is associated with worse clinical outcomes, greater healthcare costs and increased risk of antimicrobial resistance. OBJECTIVES: To evaluate the completeness of allergy history taking as per Trust guidelines on penicillin allergy classification, for patients with a positive penicillin allergy status presenting through the Emergency Department (ED) at the Royal Berkshire Hospital (RBH). METHODS: In the first audit, 30 consecutive patients prescribed antibiotics in the acute medical unit (AMU) via ED at RBH were selected in April 2021. Electronic patient records were reviewed for the percentage documentation of the causative antibiotic, symptoms, time and management of reaction in those with an active penicillin allergy status. Findings were fed back to the ED team at departmental teaching. Thirty consecutive patients with recorded penicillin allergy presenting to ED were selected for re-audit in June 2021. RESULTS: A small improvement in penicillin allergy history documentation was seen between the first audit and re-audit (Figure 1). However, 56% of patients' notes still lacked enough information to classify severity. Under 5% of patients' documented allergy history constituted absolute contraindication to penicillin-based antibiotics (Figure 2). CONCLUSIONS: Penicillin allergy documentation in patients presenting through ED at RBH remained below the standard of Trust guidance despite educating the ED team on the issue. This project has instigated an update in the Trust penicillin allergy classification guidelines and a multidisciplinary quality improvement project to identify and challenge inappropriate penicillin allergy labels.
format Online
Article
Text
id pubmed-8849403
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-88494032022-02-17 P38 Audit and reaudit of penicillin allergy documentation in patients presenting through the Emergency Department at the Royal Berkshire Hospital Shenoy, Aniruddh Malakouti, Afsaneh Iyer, Shabnam JAC Antimicrob Resist Posters Abstracts BACKGROUND: Penicillin allergy is the commonest reported drug allergy in the UK. However, it is estimated that under 10% are true allergies. Evidence shows that using second-line antibiotics is associated with worse clinical outcomes, greater healthcare costs and increased risk of antimicrobial resistance. OBJECTIVES: To evaluate the completeness of allergy history taking as per Trust guidelines on penicillin allergy classification, for patients with a positive penicillin allergy status presenting through the Emergency Department (ED) at the Royal Berkshire Hospital (RBH). METHODS: In the first audit, 30 consecutive patients prescribed antibiotics in the acute medical unit (AMU) via ED at RBH were selected in April 2021. Electronic patient records were reviewed for the percentage documentation of the causative antibiotic, symptoms, time and management of reaction in those with an active penicillin allergy status. Findings were fed back to the ED team at departmental teaching. Thirty consecutive patients with recorded penicillin allergy presenting to ED were selected for re-audit in June 2021. RESULTS: A small improvement in penicillin allergy history documentation was seen between the first audit and re-audit (Figure 1). However, 56% of patients' notes still lacked enough information to classify severity. Under 5% of patients' documented allergy history constituted absolute contraindication to penicillin-based antibiotics (Figure 2). CONCLUSIONS: Penicillin allergy documentation in patients presenting through ED at RBH remained below the standard of Trust guidance despite educating the ED team on the issue. This project has instigated an update in the Trust penicillin allergy classification guidelines and a multidisciplinary quality improvement project to identify and challenge inappropriate penicillin allergy labels. Oxford University Press 2022-02-16 /pmc/articles/PMC8849403/ http://dx.doi.org/10.1093/jacamr/dlac004.037 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Posters Abstracts
Shenoy, Aniruddh
Malakouti, Afsaneh
Iyer, Shabnam
P38 Audit and reaudit of penicillin allergy documentation in patients presenting through the Emergency Department at the Royal Berkshire Hospital
title P38 Audit and reaudit of penicillin allergy documentation in patients presenting through the Emergency Department at the Royal Berkshire Hospital
title_full P38 Audit and reaudit of penicillin allergy documentation in patients presenting through the Emergency Department at the Royal Berkshire Hospital
title_fullStr P38 Audit and reaudit of penicillin allergy documentation in patients presenting through the Emergency Department at the Royal Berkshire Hospital
title_full_unstemmed P38 Audit and reaudit of penicillin allergy documentation in patients presenting through the Emergency Department at the Royal Berkshire Hospital
title_short P38 Audit and reaudit of penicillin allergy documentation in patients presenting through the Emergency Department at the Royal Berkshire Hospital
title_sort p38 audit and reaudit of penicillin allergy documentation in patients presenting through the emergency department at the royal berkshire hospital
topic Posters Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849403/
http://dx.doi.org/10.1093/jacamr/dlac004.037
work_keys_str_mv AT shenoyaniruddh p38auditandreauditofpenicillinallergydocumentationinpatientspresentingthroughtheemergencydepartmentattheroyalberkshirehospital
AT malakoutiafsaneh p38auditandreauditofpenicillinallergydocumentationinpatientspresentingthroughtheemergencydepartmentattheroyalberkshirehospital
AT iyershabnam p38auditandreauditofpenicillinallergydocumentationinpatientspresentingthroughtheemergencydepartmentattheroyalberkshirehospital