使用假的青霉素过敏标签与住院时间延长和患C的风险增加有关。difficile和MRSA。在英国一家大型教学医院进行的这项研究中,在外科术前评估诊所(POAC)就诊的患者报告青霉素过敏,由护理人员或药房人员直接去标签,在适当的地方。可能直接去标记的三名患者中有两名接受了替考拉宁作为预防措施,并在诱导时出现过敏反应。
方法:报告青霉素过敏的患者在常规POAC预约时被确认。作者采用了一种专为非过敏症患者设计的青霉素过敏去标签工具;向护理人员提供了支持信息和教育,以消除虚假标签。抗菌药剂师(AMPs)提供了随访,交叉检查预防性使用的抗生素,询问临床笔记并在手术后致电患者,了解所遭受的任何不良反应的详细信息。
结果:确定了一百六十三(163)名报告青霉素过敏的患者进行干预。29例(17.8%)患者报告了青霉素过敏史,适合直接去标记,其中8例(27.6%)拒绝同意。其余21名患者(12.8%)直接去标签,12名(7.4%)患者在POAC预约期间同意;其余9名(5.5%)患者在手术后通过AMP同意并去标签。
结论:POAC被确定为患者途径中的适当位置和时间点,以便在手术前直接去除假青霉素过敏标签。结果表明,这可以由护理人员进行,尽管来自AMP的支持使得更多的患者被去标记。
BACKGROUND: Having a false penicillin-allergy label is linked to longer hospital stays and to an increased risk of Clostridioides difficile and meticillin-resistant Staphylococcus aureus infection.
OBJECTIVE: To assess a penicillin-allergy de-labelling tool designed for use by the non-allergist.
METHODS: Patients attending the surgical preoperative assessment clinic (POAC) at a large UK teaching hospital, who reported a penicillin allergy, were directly de-labelled by nursing or pharmacy staff, where appropriate. A penicillin-allergy de-labelling tool designed for use by the non-allergist was adapted and applied; nursing staff were provided with supporting information and education to enable removal of spurious labels. Antimicrobial pharmacists (AMPs) provided follow-up, cross-checked prophylactic antibiotics administered, interrogated clinical notes, and telephoned patients following their surgery, for details of any adverse reactions suffered.
RESULTS: A total of 163 patients reporting a penicillin allergy were identified for intervention. Twenty-nine (17.8%) patients reported a penicillin-allergy history appropriate for direct de-labelling, of whom eight (27.6%) declined to consent. The remaining 21 patients (12.8%) were directly de-labelled, with 12 (7.4%) patients consenting during their POAC appointment; the remaining nine (5.5%) patients were consented and de-labelled after their surgery by an AMP.
CONCLUSIONS: The POAC was identified as an appropriate location and time-point in the patient pathway to enable the direct removal of spurious penicillin-allergy labels prior to surgery. Results suggest that this could be undertaken by nursing staff, although support from AMPs enabled a greater number of patients to be de-labelled.