Evaluation of penicillin allergy labeling in the emergency department: Retrospective study on the impact of a hospital pharmacist-led intervention algorithm.

IF 1.3 Q4 PHARMACOLOGY & PHARMACY

FARMACIA HOSPITALARIA Pub Date : 2025-06-30 DOI:10.1016/j.farma.2025.05.013

Fernando Salazar González, Mireia Iglesias Rodrigo, Gemma Garreta Fontelles, Mireia Mensa Vendrell, Jordi Nicolás Picó

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Abstract

Objective: To evaluate the impact of an intervention algorithm on penicillin allergy label reassessment in emergency department patients, aiming to optimize antibiotic selection and improve patient safety.

Methods: A retrospective observational study was conducted in a 450-bed hospital, including adult patients with a penicillin allergy label admitted to the emergency department between November 2023 and August 2024. An algorithm developed by the pharmacy service in collaboration with the ASP team was applied, based on validated tools such as the Penicillin Allergy De-Labelling Toolkit, PEN-FAST, and Antibiotic Allergy Assessment Tool. Demographic data, allergy history, and clinical outcomes were collected. The acceptance of recommendations and the incidence of adverse reactions were analyzed.

Results: A total of 66 patients were evaluated. Delabeling was proposed in 35 (53.03%) patients, skin testing in 13 (19.69%), oral provocation testing in 9 (13.63%), and label maintenance in 9 (13.63%). A total of 89.39% of the recommendations were accepted, achieving effective delabeling in 42 patients. No adverse reactions were recorded. In 21 cases, antibiotic therapy was optimized following the intervention.

Conclusions: The implementation of a structured algorithm for penicillin allergy reassessment in emergency settings is effective and safe. Its application facilitates antibiotic optimization, improves patient safety, and reduces broad-spectrum antibiotic use. This study highlights the role of hospital pharmacists in drug allergy management and antimicrobial stewardship.

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急诊科青霉素过敏标签评价：医院药师主导干预算法影响的回顾性研究。

目的：评价一种干预算法对急诊科患者青霉素过敏标签重评的影响，优化抗生素选择，提高患者安全。方法：在一家拥有450个床位的医院进行回顾性观察研究，包括2023年11月至2024年8月期间急诊科收治的青霉素过敏成人患者。基于青霉素过敏去标签工具包、PEN-FAST和抗生素过敏评估工具等经过验证的工具，应用了药房服务与ASP团队合作开发的算法。收集了人口统计数据、过敏史和临床结果。分析建议的接受程度和不良反应的发生率。结果：共评估66例患者。35例（53.03%）患者建议去标签，13例（19.69%）患者建议皮肤试验，9例（13.63%）患者建议口服激发试验，9例（13.63%）患者建议标签维持。共有89.39%的建议被接受，42例患者实现了有效的去标签。无不良反应记录。在21例中，抗生素治疗在干预后得到优化。结论：在紧急情况下实施结构化的青霉素过敏再评估算法是有效和安全的。它的应用促进了抗生素的优化，提高了患者的安全性，并减少了广谱抗生素的使用。本研究强调医院药师在药物过敏管理和抗菌药物管理中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

FARMACIA HOSPITALARIA PHARMACOLOGY & PHARMACY-

CiteScore

1.90

自引率

21.40%

发文量

审稿时长

37 days

期刊介绍： Una gran revista para acceder a los mejores artículos originales y revisiones de la farmacoterapia actual. Además, es Órgano de expresión científica de la Sociedad Española de Farmacia Hospitalaria, y está indexada en Index Medicus/Medline, EMBASE/Excerpta Médica, Alert, Internacional Pharmaceutical Abstracts y SCOPUS.