Reducing Unnecessary Penicillin Allergy Labels in the Pediatric Surgical Population.

Abstract

Background: Up to 10% of children report having a penicillin allergy; however many of these are misdiagnoses or the allergy resolves over time. Having an unnecessary penicillin allergy label increases risk of adverse clinical outcomes and increased health care costs.

Local problem: At our local pediatric surgical center, the percentage of patients with a penicillin allergy label was 7%.

Methods: A pre/postimplementation design was used.

Interventions: Pediatric surgical patients with a penicillin allergy label were identified and risk-stratified to undergo a single-dose oral provocation test (OPT) to amoxicillin.

Results: Forty-two patients underwent an OPT. The percentage of patients with a penicillin allergy label decreased to 6.4% after 6 months ( P = .045). Median wait time for an allergy evaluation decreased from 102 to 42 days ( P < .0001).

Conclusions: This quality improvement project decreased penicillin allergy labeling rates in pediatric surgical patients, improved access to penicillin allergy evaluation, and had no adverse outcomes.