Journal article
Assessing the safety of increased outpatient cephalosporin use following the modification of penicillin allergy cross-reactivity alerts
Infection control and hospital epidemiology, Vol.46(4), pp.416-421
04/2025
DOI: 10.1017/ice.2025.9
PMID: 40079207
Abstract
Concerns about penicillin-cephalosporin cross-reactivity have historically led to conservative prescribing and avoidance of cephalosporins in patients with penicillin allergy labels, potentially causing suboptimal outcomes. Recent evidence suggests a lower risk of cross-reactivity, prompting a reassessment of alert systems.
To assess the impact of limited penicillin cross-reactivity alerts on outpatient cephalosporin use and the incidence of adverse reactions in a healthcare setting.
This retrospective cohort study compared cephalosporin prescribing and adverse reactions in patients labeled as penicillin-allergic before and after limiting penicillin cross-reactivity alerts in the electronic medical record at a large academic medical center.
Among 17,174 patients (8,131 pre- and 9,043 post-implementation), there was a statistically significant increase in outpatient cephalosporin prescribing by 8% (
< .001). The use of alternative antibiotic classes decreased. There was no statistically significant increase in adverse events pre- and post-implementation (0.036%-0.058%,
= .547), and no severe events were attributable to cross-reactivity. The alert modification reduced alerts by 92% (
< .001).
The reduction of penicillin-cephalosporin cross-reactivity alerts was associated with increased cephalosporin use, without a significant increase in adverse reactions. This demonstrates that the practice is safe and decreases alert burden.
Details
- Title: Subtitle
- Assessing the safety of increased outpatient cephalosporin use following the modification of penicillin allergy cross-reactivity alerts
- Creators
- Bryan Schneider - University of Iowa Health CareKelly M Percival - University of IowaAnna M Rhinehart - Department of Pharmaceutical Care, University of Iowa Health Care, Iowa City, IA, USAJared Frye - University of Iowa Health CareDeanna L McDanel - University of IowaKevin L Bebout - University of Iowa Health CareLukasz D Weiner - University of IowaSarah A Auerbach - University of IowaAmy M Dowden - University of IowaDilek Ince - University of IowaPatrick Kinn - University of Iowa Health Care
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.46(4), pp.416-421
- DOI
- 10.1017/ice.2025.9
- PMID
- 40079207
- NLM abbreviation
- Infect Control Hosp Epidemiol
- ISSN
- 1559-6834
- eISSN
- 1559-6834
- Publisher
- CAMBRIDGE UNIV PRESS
- Language
- English
- Electronic publication date
- 03/13/2025
- Date published
- 04/2025
- Academic Unit
- Infectious Diseases; Stead Family Department of Pediatrics; Pharmacy Practice and Science; Immunology; Infectious Disease (Pediatrics); Internal Medicine
- Record Identifier
- 9984800202402771
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