Impact of a Pharmacist Driven Penicillin Allergy De-labeling Protocol on Rates of Reported Allergy in the Intensive Care Unit

Abstract

Inaccurate penicillin allergy labels (PALs) results in use of broader, less optimized antibiotics. Studies have shown challenging low-risk PALs is safe and effective. We assessed the proportion of PALs among critically ill patients after a pharmacist driven allergy de-labeling program was implemented in the medical intensive care unit (MICU) between November 2017 and March 2023. There was a notable reduction in the proportion of PALs pre-intervention (14.0%) and post-intervention (12.8%). Persistent reductions in the proportion of PALs among readmitted patients was seen in both MICU (21.4% to 15.9%) and non-MICU patients (13.8% to 11.1%). This study further emphasizes the potential for proactive surveillance and intervention on low-risk PALs by pharmacists to reduce the burden of broad-spectrum antibiotics, which may optimize antibiotic usage and possibly impact institutional antimicrobial spectrum.