J Pharmacoepidemiol Risk Manage.  2020 Sep;12(2):63-69.

Proper Antimicrobial Stewardship in Terms of Management of Drug Allergy

• Kim SH

Abstract

Antimicrobial stewardship (antibiotic stewardship) refers to a systematic and organized strategy and performance system that seeks to establish evidence-based antibiotic prescriptions to reduce resistance and unnecessary abuse of antibiotics while improving treatment effectiveness. Recent guideline for antimicrobial stewardship recommends the antibiotic stewardship program should further enhance the assessment of antibiotic drug allergies, including penicillin skin tests, in order to more effectively and successfully use primary antibiotics in patients with a history of allergies to beta-lactam antibiotics. Drug allergy labels, such as penicillin allergy, have been determined without accurate evaluation in a number of cases and serve as an important clinical factor that hinders proper antibiotic use. De-labeling of an improperly misdiagnosed penicillin allergic patient has attracted attention, and many recent studies have reported that after accurate penicillin allergy evaluation, de-labeling has improved in terms of cost and effectiveness through the use of appropriate antibiotics. It is necessary to prepare a system that has referral systems and protocols to accurately evaluate and diagnose drug allergies in hospitals, and to continuously update and correct drug allergy labels on electronic medical records. Through systematic management of drug allergies and adverse drug reactions, more successful antibiotic stewardships can be established.

Keyword

Antimicrobial stewardship; Drug allergy; Penicillin allergy