Abstract
Background
Collaborations between medication safety and antimicrobial stewardship programs (ASP) have not been well described despite many overlapping best practice initiatives. In partnership with medication safety, the ASP at Houston Methodist (HM) reviews patient safety events submitted by hospital staff and identified a best practice opportunity in allergy reporting practices. Our objective was to benchmark self-reported antibiotic allergies among hospitalized patients and compare the prevalence and characteristics among hospital settings.
Methods
We evaluated the prevalence of self-reported antibiotic allergies in the electronic medical record for adult patients admitted to any HM entity including 1 flagship referral center (933-beds) and 6 community-based hospitals (1,379-beds) in January 2019. Antibiotics were grouped by class into penicillins, sulfas, cephalosporins, tetracyclines, macrolides, quinolones, and others. Point-prevalence rates were calculated using the total patient count as the denominator.
Results
There were 4,730 patients admitted to HM in January 2019 of which 85% (n = 4,029) self-reported 9,186 active drug allergies. There were 2,353 (49.7%) individuals who self-reported 3,665 antibiotic allergies, of which 987 (21%) reported an allergy to ≥2 antibiotic classes. The prevalence rate for a penicillin allergy was highest at 26.1% (n = 1,235), followed by allergy to sulfa 15.9% (n = 751) and quinolones 7.9% (n = 411). Antibiotic allergies were most prevalent in patients aged 70–79 (11%, n = 518) and 60–69 (10%, n = 495). Antibiotic allergies were higher among females (61.6%; n = 1,679/2,724) compared with males (40.7%; n = 662/1,305) (P = 0.002). There was no difference in prevalence rates between community-based hospitals and the flagship institution (P = 0.51).
Conclusion
We identified an antibiotic allergy point prevalence rate of 49.7% among hospitalized patients, including a 26.1% rate to penicillin, across our 7-hospital system. This analysis provides a road map to deploy system-wide efforts to improve antibiotic detailing in patients regardless of the hospital setting.
Disclosures
All authors: No reported disclosures.
Intervention fidelity and process outcomes of the IMMENSE study, a pharmacist‐led interdisciplinary intervention to improve medication safety in older hospitalized patients
