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Tolerating Penicillin-Based Antibiotics


What percentage of patients with a reported penicillin allergy will tolerate penicillin antibiotics?

a. 10%

b. 20%

c. 50%

d. 90%

Answer: d

You probably got that question right if you’re a pharmacist, because pharmacists know more about penicillin allergy than other members of the patient care team. That’s according to 276 surveys completed by non-allergist physicians, physician assistants, nurse practitioners, and pharmacists at Rochester Regional Health in upstate New York. Three-fourths of the pharmacists knew that more than 90% of patients labeled with a penicillin allergy tolerate penicillin-based antibiotics, compared with only a quarter of the other providers.

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The survey also revealed that 78% of pharmacists knew penicillin allergy can resolve over time, but only 55% of the other respondents realized that was true. Experience wasn’t a factor in the lack of knowledge about penicillin allergy among the physicians — most had been practicing for more than 10 years.

Optimizing antimicrobial therapy demands a multidisciplinary approach in order to reduce the use of second-line antibiotics, which increase the cost of care and are more likely to cause unwanted side effects, pointed out Mary Staicu, PharmD, lead author of the study and an infectious disease pharmacist at Rochester Regional Health (Ann Allergy Asthma Immunol. 2017 Jul;119(1):42-47). Dr. Staicu said there’s an overall limited understanding among healthcare providers about how to manage penicillin-allergic patients, but she wasn’t surprised that pharmacists grasped the course of penicillin allergy better than other clinicians, given their more extensive pharmacology education. She was surprised, however, by the lack of coordination between allergists and non-allergist providers: 86% of respondents indicated that they never consult an allergist or do so only once per year, despite that up to 15% of inpatients in the United States claim they’re allergic to penicillin.

The survey revealed a knowledge gap when it comes to managing patients with a penicillin allergy and indicated efforts must be made to educate the healthcare community at large about recommended treatment approaches, according to Dr. Staicu.

Dan Cook

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