Pharmacist-managed service providing penicillin allergy skin tests

Am J Health Syst Pharm. 2004 Jun 15;61(12):1271-5. doi: 10.1093/ajhp/61.12.1271.

Abstract

Purpose: A penicillin allergy skin-testing service run by pharmacists is described.

Summary: A board-certified allergist trained pharmacists at a tertiary care teaching hospital to administer penicillin allergy skin tests and interpret the results. A major objective of the service was to avoid unnecessary use of vancomycin and quinolones in patients claiming but not actually having a penicillin allergy. Patients with a severe type I reaction to penicillin during the preceding five years, patients with a confirmed history of a type II-IV reaction to penicillin, and severely immunosuppressed patients were not eligible for testing. As of July 2003, 26 patients had been enrolled in the service. A type I penicillin reaction was ruled out by the drug allergy history for 3 patients. The results were negative in 22 of the 23 patients who received skin testing, and in 1 the result was indeterminate. A penicillin or a beta-lactam antibiotic was administered to all 26 patients. No patient had a significant adverse reaction to skin testing or drug administration.

Conclusion: A pharmacist-managed penicillin allergy skin-testing service was well received by physicians and showed potential to avoid unnecessary use of alternative antibiotics.

MeSH terms

  • Academic Medical Centers
  • Anti-Bacterial Agents / administration & dosage
  • Drug Hypersensitivity / classification
  • Drug Hypersensitivity / diagnosis*
  • Drug Hypersensitivity / prevention & control
  • Education, Pharmacy, Continuing / methods
  • Hospitals, Teaching
  • Humans
  • Iowa
  • Ofloxacin / administration & dosage
  • Penicillins / adverse effects*
  • Penicillins / therapeutic use
  • Pharmacists
  • Pharmacy Service, Hospital / methods*
  • Professional Role
  • Program Development
  • Records
  • Skin Tests / methods*
  • Vancomycin / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Penicillins
  • Vancomycin
  • Ofloxacin