Penicillin Allergy
About 10% of the population is labeled as penicillin allergic but only this percentage are truly allergic to penicillin.
What is <1% of the population?
This is the time frame for prospective auditing and feedback after an antibiotic is started.
What is 48 to72 hours?
UTI treatment guidelines should include this monitoring option that can help avoid over treatment of ASB.
What is a ‘watch and Wait’ protocol?
Tracking annual susceptibility rates for selected bug-drug combinations of interest (example: Pseudomonas aeruginosa or E.coli susceptibility to ciprofloxacin) can be used to show the impact of this.
What is antibiotic stewardship program actions?
This is a common reason why so many people are labeled as penicillin allergic but are not actually allergic (name one or more).
What is 1) penicillin allergy goes away over time or 2) the original penicillin reaction was a side effect mislabeled as an allergy?
This AS action is done to preserve antibiotics generally used for MDROs.
What is preauthorization?
These drugs are NOT recommended as first-line empiric therapy for most UTIs in long-term care and elderly patients due to bacterial resistance and risk of serious side effects
What are fluoroquinolones?
These antibiotic stewardship "process" measures should be tracked and reported (hint: think prospective audit and feedback). Name one or more
What are antibiotic stewardship interventions and prescriber acceptance rate?
Patients with a penicillin allergy label are more likely to experience these negative outcomes (name two or more).
What is 1) lower clinical cure rate, 2) increased side effects, 3) increased bacterial resistance?
Prospective audit and feedback typically involves recommending these two types of changes to empiric therapy (based on symptom improvement and lab/culture results)
What are discontinuation, and de-escalation (narrowing) of therapy?
A UTI treatment guideline should clearly discourage the use of antibiotics for this condition.
What is asymptomatic bacteriuria?
Performing this is good way to assess whether an AS program is meeting all of the CDC core elements.
What is a gap analysis?
This simple procedure can be done (following a medication and allergy history review) to remove a penicillin allergy label so long as the individual has a "low-risk" penicillin allergy.
What is an amoxicillin challenge?
Facilities that practice prospective audit and feedback often pair feedback with this to reinforce long-term prescribing improvements
What is prescriber education?
This facility data should be reviewed annually to ensure UTI empiric treatment guidelines remain effective.
What is the facility antibiogram?
Facility specific treatment guidelines should be audited periodically to ensure this.
What is prescriber adherence to guidelines?