Allergies, Author Interviews, JAMA / 18.01.2019 Interview with: ESS= Erica S. Shenoy, MD, PhD Harvard Medical School Division of Infectious Diseases, Department of Medicine Massachusetts General Hospital, Boston KGB= Kimberly G. Blumenthal MD, MSc Division of Rheumatology, Allergy and Immunology Department of Medicine, Massachusetts General Hospital,Boston   EMM= Eric M. Macy MD, MS Department of Allergy Southern California Permanente Medical Group San Diego Medical Center TR= Theresa Rowe, DO, MS General Internal Medicine and Geriatrics Feinberg School of Medicine Northwestern University, Chicago, Illinois What is the background for this review? ESS: A key component of reducing antimicrobial resistance is improving how antimicrobials are prescribed—both reducing inappropriate use (i.e., not prescribing when not needed) and favoring the use of narrow-spectrum agents that are less likely to contribute to the development of antimicrobial resistance. KGB: Because unverified penicillin allergy labels are so prevalent with greater than 32 million Americans affected, and these labels lead to the use of alternative antibiotics that are often more broad-spectrum, we now know that penicillin allergy evaluations are an emerging important component of antibiotic stewardship.  When patients with a reported penicillin allergy are tested, more than 95% of them are not allergic, and thus could (and should) receive penicillins, and often related drugs, when appropriate. (more…)
Allergies, Author Interviews, Infections / 23.08.2016 Interview with: Emily L. Heil, PharmD, BCPS-AQ ID Assistant Professor Department of Pharmacy Practice and Science University of Maryland School of Pharmacy 20 N Pine St Baltimore, Maryland 21201 What is the background for this study? Response: As many as nine out of ten people who think they are allergic to penicillin are, in fact, not allergic when penicillin allergy skin testing is performed. This mistaken belief, confirmed in multiple other studies and a matter of concern of the U.S. Centers for Disease Control and Prevention (CDC), has widespread implications given that patients who report penicillin allergies tend to get suboptimal antibiotic therapy compared with patients who do not. Penicillin skin testing (PST) can clarify allergy histories but is often limited by access to testing. We aimed to implement an infectious disease (ID) fellow managed PST program and to assess the need for PST via national survey. Our study found that inpatient Penicillin skin testing can be successfully managed by ID fellows, thereby promoting optimal antibiotic use. Our study showed that by testing patients for penicillin allergy via skin test, we could improve their care: 80 percent of patients were able to switch to more effective antibiotic therapy once they were tested. (more…)