Penicillin-Allergie – tödliche „Fake News“ in der Krankenakte?

Schulz-Stübner, Sebastian

doi:10.1055/a-1099-2902

Cited by 4 publications

(2 citation statements)

References 23 publications

(4 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[22][23][24] Various investigations have explored the precision of a historybased questionnaire for the assessment of antibiotic allergies. [25][26][27] In preoperative contexts, a structured allergy history increased beta-lactam prophylaxis by 277 (57%) cases out of 485 patients, reducing alternative antibiotic use from 81.9% to 55.9%. 28 Similarly, systematic preoperative checklist excluded IgE-mediated reactions in 337 (67%) of 503 self-reported antibiotic allergies and in a multicenter study, a clinical decision rule accurately identified low-risk penicillin allergies with a 96.3% negative predictive value.…”

Section: Discussionmentioning

confidence: 99%

Assessing the rationale of prescribing carbapenems among hospitalized patients with documented penicillin allergy: implications for stewardship

Burgener-Gasser,

Fasel,

Halbeisen

et al. 2024

ASHE

View full text Add to dashboard Cite

Background: A reported history of penicillin allergy frequently leads to the prescription of carbapenems as a substitute for penicillin to avoid allergic reactions. Such self-reported allergies need to be accurately characterized to identify targeted antibiotic stewardship interventions that potentially minimize unnecessary carbapenem use. Design: Retrospective cohort study. Method: The proportion of hospitalized patients with penicillin allergy history receiving carbapenem prescriptions was evaluated between January 1st, 2017 and December 31st, 2018 at the University Hospital Basel, Switzerland. The appropriateness of carbapenem prescription of each patient was evaluated using institutional guidelines based on previously published recommendations. Results: Our analysis revealed that among 212 patients with recorded penicillin allergy, of the 247 carbapenem treatment episodes, 79 (32%) were unjustified. Abdominal and lower respiratory tract infections were most frequently associated with inappropriate carbapenem use (OR 2.64, 95% CI 1.22–5.71, P = .014 and OR 2.26, 95% CI 1.08–4.73, P = .031). The recorded allergy type was not documented or unclear in 153 patients (72%) and penicillin allergy was only confirmed in 2 patients (0.9%). Inconsistencies in allergic symptom documentation and allergy types were found between the institution’s two software programs. Conclusion: While a multimodal approach to identify and accurately label penicillin allergies remains essential to reduce inappropriate carbapenem use, our findings highlight the need for comprehensive and easily accessible guidelines for carbapenem utilization and structured history-based allergy assessment as an initial screening tool, embedded in a tailored digital allergy record template.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessing the rationale of prescribing carbapenems among hospitalized patients with documented penicillin allergy: implications for stewardship

Burgener-Gasser,

Fasel,

Halbeisen

et al. 2024

ASHE

View full text Add to dashboard Cite

show abstract

“…Nicht verifizierte "Penicillin-Allergien" wurden in den vergangenen Jahren als ein zunehmendes Public-Health-Problem mit dadurch ansteigender Dauer der Hospitalisierung, höheren Wiederaufnahmeraten, häufigerem Behandlungsversagen und vermehrten Aufnahmen auf der Intensivstation erkannt, wobei eine deutlich erhöhte Exposition gegenüber Antibiotikaklassen, die mit einem erhöhten Risiko für Clostridioides-difficile-Infektionen einhergehen und als Treiber der Resistenzentwicklung für Methicillin-resistente Staphylococcus aureus (MRSA) und multiresistente gramnegative Erreger (MRGN) gelten, beobachtet wurde (Schulz-Stübner 2019).…”

Section: Wie Kann Ich Es Umsetzen?unclassified