NP-005 Penicillin allergy awareness and de-labelling

<h3>Background and Importance</h3> Approximately 10% of inpatients are labelled as penicillin allergic but the vast majority have not experienced a true allergic reaction. Having a label of penicillin allergy results in patients receiving sub-optimal alternative antibiotics and this may lead to poorer outcomes and increased costs. It is therefore beneficial to assess whether patients have experienced a true allergic reaction and consider removing the allergy label in those that have not.¹ <h3>Aim and Objectives</h3> To introduce a penicillin allergy de-labelling service in Cavan and Monaghan Hospital. To increase the documentation of drug and nature of reaction for patients with a self-reported penicillin allergy in the medication allergy assessment box by 10% over a 6-month period. <h3>Materials and Methods</h3> The Antimicrobial Stewardship (AMS) Pharmacists adapted the Scottish Antimicrobial Prescribing Group (SAPG) penicillin allergy toolkit² complying with local governance requirements. This is designed to be used by non-allergy specialists and supports the identification and removal of penicillin allergy labels in patients who do not have a history of Type 1 or 4 hypersensitivity reactions.¹ We undertook education on the toolkit and on penicillin allergy assessment with staff and we support the process. It is also available on our AMS Application. <h3>Results</h3> <h3>Conclusion and Relevance</h3> There is an increased knowledge of how to assess penicillin allergy and we are de-labelling patients of penicillin allergy resulting in many being able to receive narrower spectrum/effective antimicrobials. We have incorporated this into our role and levels of staff engagement are improving with ongoing education and support. The study has been presented at national forums and is now being undertaken in other hospitals. We have also presented our results to the national Antimicrobial Resistance and Infection Control (AMRIC) Team who will hopefully implement this for use nationally. <h3>References</h3> The Pharmaceutical Journal. We need a national de-labelling drive for patients with penicillin allergy. <i>The Pharmaceutical Journal</i> [Online]; 2020;<b>304</b>(7938). Available from: DOI:10.1211/PJ.2020.20208042 [Accessed 5 August 2022] The Scottish Antimicrobial Prescribing Group, Penicillin Allergy De-labelling. [Homepage on the Internet]. Scotland, UK [updated 2020 August]. Available from: http;//www.sapg.scot/guidance-qi-tools/quality-improvement-tools/pencillin-allergy-de-labelling/[Accessed 28 September 2021].