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Make a choice J.N.G. Oude Elberink A. Middel

Project properties

Title	Evaluation of noted Antibiotic Allergy as an Antimicrobial Stewardship Intervention
Keywords	Antibiotic allergy Antimicrobial Stewardship Antimicrobial resistance
Researchers	J.N.G. Oude Elberink A. Middel
Nature of the research	Descriptive/prevalence research
Fields of study	microbiology internal medicine allergology

Background / introduction

Infections due to antibiotic-resistant bacteria are a threat to modern health care and is mainly caused by incorrect or inappropriate use of antimicrobial therapy. One reason for inappropriate antimicrobial therapy are noted allergies to antibiotics, in particular penicillin. Beside a raise in antimicrobial resistance, the use of alternative antimicrobial therapy due to noted antibiotic allergies leads to higher morbidity, mortality and costs. Penicillin is the most common drug allergy noted at hospital admission but most subjects with a history of penicillin allergy are not allergic after evaluation by an allergist and will tolerate future penicillin use. Antimicrobial stewardship programs are worldwide implemented to target the problem of the increasing antimicrobial resistance. One of the interventions to improve appropriate use of antimicrobials is to delabel noted allergies to antimicrobials.

Research question / problem definition

The goal of this project is to evaluate the prevalence of noted drug allergies in general in the electronic patient chart EPIC of the UMCG. Subsequently there will be a specific scope on labeled antibiotic allergy, in particular penicillin allergy. Furthermore labeled antibiotic allergies will be analyzed by classification (eg type I, type IV allergy) and severity of the reactions. This information will enable us to start the subsequent projects: - to analyze the financial impact of allergy labels on the budget of the UMCG - to develop an algorithm on how to import relevant drug allergies in an electronic patient chart in the future. - To analyze antibiotic allergies in specific patient groups with high susceptibility for infections, for example a (potential) transplantation patient, leading to an intervention strategy for allergy evaluation in this group.

Workplan
Extraction of noted drug allergy information in the electronic patient system EPIC of the UMCG in general. Subsequently the scope will be on the labeling of antibiotic allergies by severity, antibiotic group and specific drugs in each of these groups.

References
Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin "allergy" in hospitalized patients: A cohort study. J Allergy Clin Immunol. 2014 Mar;133(3):790-6. doi:10.1016/j.jaci.2013.09.021. Epub 2013 Nov 1.