PMID- 34737539 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220428 IS - 1078-4497 (Print) IS - 1945-337X (Electronic) IS - 1078-4497 (Linking) VI - 38 IP - 9 DP - 2021 Sep TI - Implementation and Impact of a beta-Lactam Allergy Assessment Protocol in a Veteran Population. PG - 420-425 LID - 10.12788/fp.0172 [doi] AB - BACKGROUND: Approximately 10% of the US population reports having a beta-lactam allergy, although nearly 90% do not have a true immunoglobulin E (IgE)-mediated reaction. This misconception results in using nonpreferred antibiotics, leading to antimicrobial resistance and treatment failure. To evaluate, clarify, and clear beta-lactam allergies, we implemented a pharmacist-driven beta-lactam allergy assessment (BLAA) protocol and penicillin allergy clinic (PAC). The purpose of this study was to illustrate the BLAA process, including the pharmacist-run PAC, and assess the impact on allergy clearance. METHODS: Clinical pharmacy specialists (CPS) evaluated hospitalized veterans with beta-lactam allergies, using the BLAA protocol. Eligible patients could later be seen in PAC. This was a retrospective observational review of the BLAA protocol to assess recommendations for beta-lactam antibiotic use and PAC outcomes. RESULTS: Between November 2017 and February 2020, 278 patients were evaluated, and 32 were seen in the clinic. The most common allergen was penicillin, and the most reported reaction was a rash (27%) or pruritus and urticaria (18%). Through PAC and the BLAA protocol, 86 patients (31%) were cleared for allergy removal, and 188 (68%) were cleared for alternative beta-lactams. The evaluation revealed that 274 patients (99%) were eligible to receive a beta-lactam antibiotic, and only 4 patients (1%) were recommended for avoidance of all beta-lactams. CONCLUSIONS: These findings highlight the utility of the pharmacist-driven BLAA protocol. We illustrated that most patients with documented beta-lactam allergies were eligible for alternative beta-lactams. The implementation of the BLAA protocol and pharmacist-run PAC facilitated allergy clearance and has the potential to promote alternative beta-lactam use. CI - Copyright (c) 2021 Frontline Medical Communications Inc., Parsippany, NJ, USA. FAU - Mitchell, Anna B AU - Mitchell AB AD - , and are all Clinical Pharmacy Specialists in the Department of Pharmacy; and is a Physician in the Department of Allergy/Immunology, all at the Memphis Veterans Affairs Medical Center in Tennessee. is a Clinical Pharmacy Specialist in the Department of Pharmacy at the New Mexico Veterans Affairs Health System in Albuquerque, New Mexico. is an Inpatient Pharmacy Supervisor in the Department of Pharmacy at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, Tennessee. Debendra Pattanaik is in the Department of Rheumatology at the University of Tennessee Health Science Center in Memphis. FAU - Ness, Rachel A AU - Ness RA AD - , and are all Clinical Pharmacy Specialists in the Department of Pharmacy; and is a Physician in the Department of Allergy/Immunology, all at the Memphis Veterans Affairs Medical Center in Tennessee. is a Clinical Pharmacy Specialist in the Department of Pharmacy at the New Mexico Veterans Affairs Health System in Albuquerque, New Mexico. is an Inpatient Pharmacy Supervisor in the Department of Pharmacy at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, Tennessee. Debendra Pattanaik is in the Department of Rheumatology at the University of Tennessee Health Science Center in Memphis. FAU - Bennett, Jessica G AU - Bennett JG AD - , and are all Clinical Pharmacy Specialists in the Department of Pharmacy; and is a Physician in the Department of Allergy/Immunology, all at the Memphis Veterans Affairs Medical Center in Tennessee. is a Clinical Pharmacy Specialist in the Department of Pharmacy at the New Mexico Veterans Affairs Health System in Albuquerque, New Mexico. is an Inpatient Pharmacy Supervisor in the Department of Pharmacy at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, Tennessee. Debendra Pattanaik is in the Department of Rheumatology at the University of Tennessee Health Science Center in Memphis. FAU - Bowden, Jarred E AU - Bowden JE AD - , and are all Clinical Pharmacy Specialists in the Department of Pharmacy; and is a Physician in the Department of Allergy/Immunology, all at the Memphis Veterans Affairs Medical Center in Tennessee. is a Clinical Pharmacy Specialist in the Department of Pharmacy at the New Mexico Veterans Affairs Health System in Albuquerque, New Mexico. is an Inpatient Pharmacy Supervisor in the Department of Pharmacy at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, Tennessee. Debendra Pattanaik is in the Department of Rheumatology at the University of Tennessee Health Science Center in Memphis. FAU - Elliott, Whitney V AU - Elliott WV AD - , and are all Clinical Pharmacy Specialists in the Department of Pharmacy; and is a Physician in the Department of Allergy/Immunology, all at the Memphis Veterans Affairs Medical Center in Tennessee. is a Clinical Pharmacy Specialist in the Department of Pharmacy at the New Mexico Veterans Affairs Health System in Albuquerque, New Mexico. is an Inpatient Pharmacy Supervisor in the Department of Pharmacy at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, Tennessee. Debendra Pattanaik is in the Department of Rheumatology at the University of Tennessee Health Science Center in Memphis. FAU - Gillion, Amanda R AU - Gillion AR AD - , and are all Clinical Pharmacy Specialists in the Department of Pharmacy; and is a Physician in the Department of Allergy/Immunology, all at the Memphis Veterans Affairs Medical Center in Tennessee. is a Clinical Pharmacy Specialist in the Department of Pharmacy at the New Mexico Veterans Affairs Health System in Albuquerque, New Mexico. is an Inpatient Pharmacy Supervisor in the Department of Pharmacy at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, Tennessee. Debendra Pattanaik is in the Department of Rheumatology at the University of Tennessee Health Science Center in Memphis. FAU - Pattanaik, Debendra N AU - Pattanaik DN AD - , and are all Clinical Pharmacy Specialists in the Department of Pharmacy; and is a Physician in the Department of Allergy/Immunology, all at the Memphis Veterans Affairs Medical Center in Tennessee. is a Clinical Pharmacy Specialist in the Department of Pharmacy at the New Mexico Veterans Affairs Health System in Albuquerque, New Mexico. is an Inpatient Pharmacy Supervisor in the Department of Pharmacy at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, Tennessee. Debendra Pattanaik is in the Department of Rheumatology at the University of Tennessee Health Science Center in Memphis. LA - eng PT - Journal Article DEP - 20210912 PL - United States TA - Fed Pract JT - Federal practitioner : for the health care professionals of the VA, DoD, and PHS JID - 9500574 PMC - PMC8562903 COIS- Author disclosures The authors report no actual or potential conflicts of interest with regard to this article. EDAT- 2021/11/06 06:00 MHDA- 2021/11/06 06:01 PMCR- 2021/09/01 CRDT- 2021/11/05 06:45 PHST- 2021/11/05 06:45 [entrez] PHST- 2021/11/06 06:00 [pubmed] PHST- 2021/11/06 06:01 [medline] PHST- 2021/09/01 00:00 [pmc-release] AID - fp-38-09-420 [pii] AID - 10.12788/fp.0172 [doi] PST - ppublish SO - Fed Pract. 2021 Sep;38(9):420-425. doi: 10.12788/fp.0172. Epub 2021 Sep 12.