Reported Knowledge and Management of Potential Penicillin Allergy in Children.
Adult
Anti-Bacterial Agents
/ adverse effects
Cross-Sectional Studies
Drug Hypersensitivity
/ psychology
Emergency Service, Hospital
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Pediatrics
Penicillins
/ adverse effects
Physicians
/ psychology
Surveys and Questionnaires
Wisconsin
general pediatrics
pediatric emergency department
penicillin allergy
Journal
Academic pediatrics
ISSN: 1876-2867
Titre abrégé: Acad Pediatr
Pays: United States
ID NLM: 101499145
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
19
11
2018
revised:
07
01
2019
accepted:
16
01
2019
pubmed:
1
2
2019
medline:
2
10
2020
entrez:
1
2
2019
Statut:
ppublish
Résumé
Pediatric emergency medicine (PEM) and primary care provider (PCP) providers are the most likely physicians to initially label a child as allergic to penicillin. Differences in knowledge and management of reported penicillin allergy between these 2 groups have not been well characterized. A cross-sectional, 20-question survey was administered to PEM and PCPs to ascertain differential knowledge and management of penicillin allergy. Knowledge regarding high- and low-risk symptoms for true allergy and extent of history taking regarding allergy were compared between the 2 groups using t tests, Chi-square, and Wilcoxon tests. In total, 182 PEM and 54 PCPs completed the survey. PEM and PCPs reported that 74.1 ± 19.5% and 69.0 ± 23.8% of patients with remote low-risk symptoms of allergy could tolerate penicillin without an allergic reaction. PEM and PCPs incorrectly identified low-risk symptoms of allergy as high-risk, including vomiting with medication administration and delayed skin rash. PCPs took more detailed allergy histories when compared with PEM providers. In total, 143 (78.5%) of PEM providers and 51 (94.4%) PCPs were interested in using a penicillin allergy questionnaire to segregate children into high- or low-risk categories. Most pediatric providers believe that children with a remote history of low-risk allergy symptoms could tolerate penicillin without an allergic reaction; however, this is infrequently acted upon. Both PEM and PCP providers were likely to classify low-risk symptoms as high-risk and infrequently referred children for further detailed allergy assessment. Both groups were receptive to decision support measures to facilitate improved penicillin allergy classification and labeling and support antibiotic appropriateness in their patients.
Sections du résumé
BACKGROUND
Pediatric emergency medicine (PEM) and primary care provider (PCP) providers are the most likely physicians to initially label a child as allergic to penicillin. Differences in knowledge and management of reported penicillin allergy between these 2 groups have not been well characterized.
METHODS
A cross-sectional, 20-question survey was administered to PEM and PCPs to ascertain differential knowledge and management of penicillin allergy. Knowledge regarding high- and low-risk symptoms for true allergy and extent of history taking regarding allergy were compared between the 2 groups using t tests, Chi-square, and Wilcoxon tests.
RESULTS
In total, 182 PEM and 54 PCPs completed the survey. PEM and PCPs reported that 74.1 ± 19.5% and 69.0 ± 23.8% of patients with remote low-risk symptoms of allergy could tolerate penicillin without an allergic reaction. PEM and PCPs incorrectly identified low-risk symptoms of allergy as high-risk, including vomiting with medication administration and delayed skin rash. PCPs took more detailed allergy histories when compared with PEM providers. In total, 143 (78.5%) of PEM providers and 51 (94.4%) PCPs were interested in using a penicillin allergy questionnaire to segregate children into high- or low-risk categories.
CONCLUSIONS
Most pediatric providers believe that children with a remote history of low-risk allergy symptoms could tolerate penicillin without an allergic reaction; however, this is infrequently acted upon. Both PEM and PCP providers were likely to classify low-risk symptoms as high-risk and infrequently referred children for further detailed allergy assessment. Both groups were receptive to decision support measures to facilitate improved penicillin allergy classification and labeling and support antibiotic appropriateness in their patients.
Identifiants
pubmed: 30703582
pii: S1876-2859(19)30003-8
doi: 10.1016/j.acap.2019.01.002
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Penicillins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
684-690Informations de copyright
Copyright © 2019 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.