Quality in Primary Care Open Access

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Abstract

Quality Improvement Project : Inaccurate Labeling Of Penicillin Allergy In Division 1 University Athletes

  Dusty Marie Narducci

Objective: Determine the number of athletes with electronic medical record (EMR) documentation of penicillin (PCN) allergy and enroll them into a PCN relabeling program using EMR risk stratification (EMR-RS) or team physician risk stratification (TP-RS) to determine the presence of true allergy.

Design: Retrospective data analysis, prospective cohort study.

Setting: Division 1 University Athletic Program.

Patients: Athletes with an EMR document PCN allergy (27 of 415).

Interventions: Athletes labeled as allergic to PCN were enrolled into a PCN relabeling program and appropriately categorized using EMR-RS and TP-RS. Athletes who were determined appropriate were offered recommendations for potential relabeling of their PCN allergy.

Outcome Measures: This QI study sought to establish the prevalence of true PCN allergy among athletes. Both EMRRS and TP-RS relabeling strategies were used to determine which method would more accurately identify true PCN allergy.

Results: From the 6.5% of athletes identified with as allergic to PCN, TP-RS was able to identify 92.59% of athletes to be falsely labeled as allergic to PCN, compared to 40.7% identified by EMR-RS a difference of 51.89%.

Conclusions: TP-RS is superior to EMR-RS for identifying falsely documented PCN allergies in athletes. TP-RS should be used to re-label athletes to decrease the use of unnecessary antibiotics, decrease healthcare costs, limit adverse events associated with antibiotic use, and prevent antimicrobial resistance in the athletic population.