RATIONALE: Penicillin is reported as a drug allergy in 10% of the general population. We studied the epidemiology of documented penicillin allergy in patients entering the ED of an inner-city tertiary care hospital including the general prevalence, prevalence by race, and reports of multiple drug allergies, defined as 2 or more allergies. METHODS: This was a retrospective review of patients entering the ED of University Hospital from 01/2017-07/2017. We identified all patients with a documented penicillin allergy by a query of the electronic medical record, removing duplicate presentations for the same patient. The total number of patients presenting to the ED over the same time frame was identified. Excel sheet filters were used to tally the number of patients with penicillin allergy, the number of African Americans and Whites with penicillin allergy, and the number of patients with multiple drug allergies. RESULTS: Of 7291 patients presenting the ED from 01/2017 to 07/2017, 2503 (34%) had documented penicillin allergy. Penicillin allergy was documented in 45% (1390/3043) of African American patients. Similarly 46% (385/832) of White patients had documented penicillin allergy. Twenty-eight percent (701/2503) of patients with penicillin allergy also reported allergy to multiple drugs. CONCLUSIONS: The prevalence of documented penicillin allergy is greater in our inner-city tertiary care hospital than in the general population (34% versus 10%). Prevalence in the African American and White population is approximately equal, but greater than the general population. Patients with penicillin allergy are likely to report allergies to two or more drugs.
Allergy documentation is frequently incomplete and/or inaccurate in the electronic health record. The aim of this study was to evaluate the impact of inpatient drug allergy consultation on documentation and management. METHODS: After IRB approval, a retrospective chart review was performed on all drug allergy consults (N590) between July 2018-June 2019. Descriptive statistics including frequencies and percentages were calculated using Excel. RESULTS: The most common reason for consult was past history of allergy (N540, 44%), most often to beta-lactams (N545, 38%) and NSAIDs (N519, 16%) reported as pruritus (N531, 15%) and urticaria (N529, 14%). Graded dose challenge was recommended most often (N538, 42%) followed by desensitization (N523, 26%), use of alternative therapy (N516, 18%), delabeling by history alone (N59, 10%), and inpatient skin prick testing (N54, 4%). Inpatient evaluation recommendations were completed successfully in a majority of the sixty-five cases recommending inpatient evaluation (N548, 74%). The recommended evaluation wasn't performed in fifteen (21%) of the cases and was unsuccessful in two (3%). In the fifty-five cases warranting allergy history modification, the history was modified (N551, 93%) most often by the pharmacist (N518, 35%). Comments were more often made to the allergies (N527, 53%) rather than removing them (N524, 47%). CONCLUSIONS: After a majority of inpatient allergy consultations, the drug allergy documentation was modified based on the management outcome. There is still a need to clarify when an allergy should be removed versus be commented on to ensure that allergies are not inappropriately added back to the history. 292 Factors Associated with Self-Reported Multiple Drug Allergies in a Large Chronic Urticaria Cohort
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.