UTHealth Quality Symposium 2022 Abstracts-2

Abstract

Emerging evidence suggests that patients with listed drug allergy have inferior outcomes than patients without listed drug allergies. Unverified penicillin allergy can lead to utilizing less efficacious antibiotics, increased length/cost of hospital stay, and adverse effects including antibiotic resistance and Clostridium difficile infections. Reports of penicillin allergy seldom reflect tested allergy. ~0.2% of patients that undergo drug allergy testing are truly allergic to the listed medication. This project’s first aim was to assess the prevalence of penicillin allergy label in the Lyndon B. Johnson Hospital patient population: we found a 1.2% prevalence. We evaluated the reaction types and the most common reactions were rash (26%), hives (16%), angioedema/swelling (10%), and anaphylaxis (4%) – these values correlate with findings of a large, urban outpatient population. The most common subtype (36%) was undocumented/unknown reaction. There was a statistically significant difference in proportions of C. diff, MRSA, and VRE infections (p<0.001) between patients with penicillin allergy label and without. Our data demonstrates a need for awareness and education regarding a complete drug allergy history. Most acute care hospitals, including LBJ Hospital, lack access to allergy specialists and penicillin allergy diagnostic testing. It is imperative that all providers have awareness of drug allergy assessments given the implications of unverified drug allergy labels and the fact that it is possible to de-label patients based on history alone. Part II of our study will focus on resident education of accurate drug allergy history/assessment to identify patients without IgE-mediated allergy and de-labeling.