Impact of Penicillin Allergy on Empirical Carbapenem Use in Gram-Negative Bloodstream Infections: An Antimicrobial Stewardship Opportunity

Pharmacotherapy
Majdi N Al-HasanJulie Ann Justo

Abstract

Retrospective matched-cohort study evaluating association between penicillin allergy and empirical carbapenem use in gram-negative bloodstream infections (BSIs) and utility of antimicrobial stewardship interventions in reducing carbapenem utilization. Hospitalized adults with community-onset gram-negative BSI from January 1, 2010, to June 30, 2015, at two large community hospitals in Columbia, SC, were identified. Antimicrobial stewardship interventions targeting penicillin allergy and carbapenem utilization were fully implemented January 1, 2014. Multivariate logistic regression was used to examine impact of penicillin allergy and antimicrobial stewardship interventions on empirical carbapenem use. Kaplan-Meier analysis was used to evaluate time to carbapenem deescalation in patients with penicillin allergy before and after interventions. Patients with penicillin allergy (n=140) were more likely to receive empirical carbapenem therapy for community-onset gram-negative BSI compared to those without penicillin allergy (n=140) (27% vs 12%, p=0.002). After adjustments in the multivariate model, penicillin allergy (odds ratio [OR] 3.98, 95% confidence interval [CI] 1.98-8.45) and prior β-lactam use (OR 2.72, 95% CI 1.07-6.64) were ...Continue Reading

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Citations

Jan 29, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Christopher M BlandGeoffrey C Wall
Sep 2, 2019·Current Infectious Disease Reports·Kelli A ColeLisa E Dumkow
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Jan 14, 2021·International Journal of Clinical Pharmacy·Rashmeet BhogalMamidipudi T Krishna
Mar 20, 2021·Current Allergy and Asthma Reports·Tracy ZemblesDavid Vyles

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