Abstract
Objective
To remove inaccurate penicillin allergy labels in the general pediatric clinic setting.
Methods
From October 2017 through December 2021, this collaborative, quality improvement project
used education, feedback, electronic health record alerts, and the introduction of
oral amoxicillin challenges in a general pediatric clinic setting with the primary
aim of decreasing the proportion of penicillin allergy labeled patients. Control charts
were used to track the relationship between interventions and improvements in referral
rates to allergy clinic, removal of the allergy label at clinic visits and the overall
proportion of clinic patients labeled as PCN allergic.
Results
Referral rates to allergy clinic for penicillin allergy labeled patients increased
from a baseline mean of 1.9% to 20.4%. The proportion of PCN allergy labeled patients
who had the label removed during a pediatric clinic visit increased from a baseline
of 1.1% to 6.6%. The overall proportion of penicillin allergy labeled clinic patients
decreased from a baseline of 3.4% to 2.2%.
Conclusion
With adequate education and collaboration with allergists, general pediatric practitioners
can play a significant role in removing inaccurate penicillin allergy labels. Pediatricians
can remove some of the burden placed on allergists by evaluating low risk patients
in the primary care setting while referring higher risk patients to the specialist.
Keywords
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Article Info
Publication History
Published online: May 26, 2022
Accepted:
May 23,
2022
Received:
March 30,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Dr Grayson is the editor-in-chief of the Annals of Allergy, Asthma & Immunology, has served on the advisory boards for AbbVie Inc, GlaxoSmithKline, and Merck, has stock options in Invirsa, Inc, serves as a member of the board of directors of the American Board of Allergy and Immunology and the Asthma and Allergy Foundation of America, where he is chair of the Medical Scientific Council, and is a member of the American Lung Association Scientific Advisory Committee. Dr. McLaughlin and Christina Toth have no conflicts of interest.
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