PMID- 31677260
OWN - NLM
STAT- MEDLINE
DCOM- 20200506
LR  - 20231212
IS  - 1535-2900 (Electronic)
IS  - 1079-2082 (Linking)
VI  - 76
IP  - 24
DP  - 2019 Dec 2
TI  - Pharmacist-driven penicillin skin testing service for adults prescribed 
      nonpreferred antibiotics in a community hospital.
PG  - 2060-2069
LID - 10.1093/ajhp/zxz237 [doi]
AB  - PURPOSE: Results of a study evaluating the implementation and impact of a 
      pharmacist-driven penicillin skin testing (PST) service for patients prescribed 
      alternative antibiotics in the community hospital setting are reported. METHODS: 
      A prospective pilot service in which patients with a documented penicillin 
      allergy (type I, immunoglobulin E [IgE]-mediated) who were prescribed alternative 
      antibiotics received PST by a trained pharmacist was implemented; if test results 
      were negative, the allergy was de-labeled from their electronic medical record. 
      The primary objective was the percentage of patients switched to first-line 
      antibiotics. Secondary objectives included length of stay (LOS) and inpatient 
      antimicrobial costs to the health system. RESULTS: Twenty-two patients were 
      proactively identified and received PST by a pharmacist. Of those tested, all 
      were negative, with no type I (IgE-mediated) hypersensitivity reactions to the 
      test itself or to the beta-lactam antibiotic administered thereafter; 68.2% 
      (15/22) were successfully transitioned to a beta-lactam after PST. As a result, a 
      decrease in the use of fluoroquinolones and vancomycin and an increase in use of 
      narrow penicillin-based antibiotics and first- and second-generation 
      cephalosporins were observed. The mean +/- S.D. LOS per patient was 7.41 +/- 6.1 
      days, and the total cost of inpatient antimicrobial therapy to the health system 
      was $1,698.88. CONCLUSION: A pharmacist-driven PST service was successfully 
      implemented in a community hospital setting.
CI  - (c) American Society of Health-System Pharmacists 2019. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Englert, Ethan
AU  - Englert E
AD  - Department of Pharmacy, Paoli Hospital - Main Line Health, Paoli, PA.
FAU - Weeks, Andrea
AU  - Weeks A
AD  - Department of Pharmacy and Department of Medicine, Infectious Disease, Paoli 
      Hospital - Main Line Health, Paoli, PA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Am J Health Syst Pharm
JT  - American journal of health-system pharmacy : AJHP : official journal of the 
      American Society of Health-System Pharmacists
JID - 9503023
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Penicillins)
SB  - IM
EIN - Am J Health Syst Pharm. 2022 Apr 1;79(8):709. PMID: 31889180
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/administration & dosage/adverse effects
MH  - Drug Hypersensitivity/diagnosis/immunology
MH  - Drug Prescriptions/*standards
MH  - Female
MH  - Hospitals, Community/*methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Penicillins/*administration & dosage/*adverse effects
MH  - Pharmacists/*standards
MH  - Pilot Projects
MH  - *Professional Role
MH  - Prospective Studies
MH  - Skin Tests/methods
OTO - NOTNLM
OT  - PST
OT  - beta-lactam allergy
OT  - penicillin allergy
OT  - penicillin skin testing
OT  - pharmacist
OT  - pharmacy-driven
EDAT- 2019/11/05 06:00
MHDA- 2020/05/07 06:00
CRDT- 2019/11/03 06:00
PHST- 2019/11/05 06:00 [pubmed]
PHST- 2020/05/07 06:00 [medline]
PHST- 2019/11/03 06:00 [entrez]
AID - 5611147 [pii]
AID - 10.1093/ajhp/zxz237 [doi]
PST - ppublish
SO  - Am J Health Syst Pharm. 2019 Dec 2;76(24):2060-2069. doi: 10.1093/ajhp/zxz237.