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Pharmacists Investigating Adverse Penicillin Responses—Pilot Study
Author(s) -
Roberts Jason A,
Hsu Millie,
Allen Karen,
Willis Jennifer,
Barras Michael
Publication year - 2007
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2007.tb00744.x
Subject(s) - medicine , penicillin , adverse effect , penicillin allergy , intensive care medicine , flowchart , antibiotics , systems engineering , engineering , microbiology and biotechnology , biology
Background Penicillins are used first‐line for many infections and are commonly associated with adverse drug responses. Pharmacists can take a detailed adverse drug response history and provide such information to prescribers. Aim To investigate and quantify the nature of adverse penicillin responses of hospital inpatients and to develop a tool to enable pharmacists to provide recommendations on potential rechallenge of patients with a history of adverse response to penicillin. Method Patients were administered a structured interview to classify the true nature of their documented adverse penicillin responses. A literature review was undertaken to develop a flowchart to enable pharmacists to advise on penicillin rechallenge in patients with a history of adverse response to penicillin. Results 84 patients were identified and 49 (58%) met the inclusion criteria. Of these 18% had either a true penicillin allergy or were not able to recall the nature of their reaction. Of the 49 patients interviewed, 82% could be rechallenged with a penicillin. The literature review identified publications that allowed the development of a flowchart to assist pharmacists in evaluating reactions and recommending future therapy for these patients. Conclusion In this small cohort, a significant proportion of patients were considered appropriate for rechallenge with penicillins. Knowledge of the sequelae of previous exposure to penicillins can inform decisions should a penicillin be indicated for treatment. The flowchart will allow pharmacists to make recommendations to the patient's medical team.