P-1793. Revitalizing Antibiotic Selection Through De-labeling of Outdated Antibiotic Allergies: Insights to Improving Antimicrobial Stewardship from South India

Abstract Background Self-reported drug allergies need to be revised or re-assessed, often. Therefore, this study aims to assess self-reported drug allergies among patients and identify potential candidates for de-labeling outdated or inappropriate antibiotic allergies, as part of antimicrobial stewardship interventions promoting rational antibiotic prescribing, as they facilitate the use of overly-broad spectrum antibiotics contributing to increased risk of antimicrobial resistance and adverse effects.Table 1:Antibiotic allergies and Potential candidates for de-labeling in the study Methods This observational study was conducted in three tertiary care hospitals in South India from October to November 2023. Patients with drug allergy labels underwent thorough interviews utilizing the PEN-FAST clinical decision rule, adopted for risk stratification of all antibiotic allergies. The rule employed a score < 3 to identify low-risk penicillin allergies, potentially eligible for allergy de-labeling. Self-reported drug allergies were documented in an Excel sheet, with descriptive statistics were applied for analysis. Results Among 857 patients analyzed, 58 (74.3%) patients reported antibiotic allergies. Penicillin and Sulfa allergy labels were the most prevalent allergy labels. Notably, 62.5% patients with low-risk Penicillin allergy and a vast majority of patients with Sulfa and Quinolone allergy are potential candidates for de-labeling, after employing the validated tool assessing the timeframe, severity and characterization of allergic reactions. Conclusion In summary, The results of the study underscores the importance of adopting validated tools to revitalize antibiotic selection, de-labeling of > 60% inappropriate or outdated allergies and hence, enabling the use of first-line antibiotics in approximately 50-100% of the patients labeled with antibiotic allergies. Disclosures All Authors: No reported disclosures