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

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.