5PSQ-107 Analysis of beta-lactam allergies: ‘de-label your allergy’ project

<h3>Background and Importance</h3> Beta-lactams (BL) are the group of antibiotics with the highest number of reported allergic reactions. The overidentification of patients labelled as allergic is a significant factor in antibiotic management, necessitating the use of alternative antimicrobials that may be less effective, safe, and efficient. PEN-FAST(Penicillin Allergy Decision Rule) is an internationally validated tool for assessing individual risk for penicillin allergy. <h3>Aim and Objectives</h3> To review and update allergy records in the electronic prescription program(EP) of the hospital and the digital clinical history (DCH). <h3>Material and Methods</h3> This descriptive study analysed allergy records to BL in patients admitted to a tertiary care hospital from June to October 2024. Collected data included age, sex, type of recorded allergy (therapeutic group(TG) or active substance(AS)), presence of allergy studies, previous prescriptions of BL (in the last 5 years), type of reaction (diarrhoea, syncope and reaction at the injection site), PEN-FAST score, and actions taken (removing the record or referring for allergy study). PEN-FAST evaluates: reactions in the last 5 years (2 points), angioedema or anaphylaxis (2 points), severe cutaneous reaction (2 points), and necessity for treatment for the allergic episode (1 point). PEN-FAST score &lt; 3 identifies low-risk allergies. Allergy records were removed for patients scoring 0 points, while those with scores ≥2 were referred for allergy evaluation. <h3>Results</h3> 33 patients were included. The mean age was 72.3 years (SD=15.1), with 56% being female. Recorded types of allergy included: TG BL (6), penicillins (12), AS amoxicillin (8), and other BL (7). Only 3% of patients had allergy studies, and 44% had prescriptions in the last 5 years. Types of reactions included: diarrhoea (9%), syncope (6%), and reaction at the injection site (12%). PEN-FAST results showed 0 points (21 patients), 2 points (9 patients), and ≥3 points (3 patients). The allergy record was removed for 26 patients (79%), while the remainder were referred for allergy evaluation. <h3>Conclusion and Relevance</h3> The ‘De-label Your Allergy’ project has successfully identified and corrected significant discrepancies in allergy records to BL, demonstrating that the majority of patients have an incorrect allergy label. This underscores the importance of updating BL allergy records, contributing to the safe use of antibiotics. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest