BACKGROUND Reported antibiotic allergy in hospitalized patients seems to be related to more adverse events, the use of reserve antibiotics and longer hospitalization. Most patients reporting an antibiotic allergy can be de-labelled; as such, an antimicrobial stewardship intervention was set up. AIM To determine the impact of reported antibiotic allergy on the antibiotic treatment of hospitalized patients, and prevent unnecessary deviation from the preferred antibiotic treatment by a proactive antimicrobial stewardship intervention. METHODS Hospitalized patients reporting an antibiotic allergy were included in an intervention study at a teaching hospital in the Netherlands between March and May 2019. Physicians received training and were provided with a recommendation in the electronic medical record in case the preferred antibiotic treatment was unnecessarily avoided due to the allergy label and the patient was eligible for a drug challenge. FINDINGS In total, 492 patients reporting an antibiotic allergy were identified, accounting for 558 hospital admissions. In 93 cases, the antibiotic allergy label interfered with the preferred antibiotic treatment. Sixty-eight of these patients were eligible for a drug challenge, and 42 patients were challenged. In 40 (95%) of these patients, no allergic reaction was observed, and the preferred antibiotic treatment was given. Two (5%) patients developed a non-severe skin reaction after a drug challenge and continued an alternative antibiotic regimen. CONCLUSION This antimicrobial stewardship intervention can be used to provide patients with reported antibiotic allergy labels with the preferred antibiotic treatment, and to de-label them after uneventful re-exposure to the antibiotic agent.

中文翻译：

---

抗菌药物管理干预：对已报告抗生素过敏的住院患者优化抗生素治疗。

背景技术据报道住院患者的抗生素过敏似乎与更多的不良事件，使用备用抗生素以及住院时间更长有关。大多数报告有抗生素过敏的患者可以取消标签。因此，建立了抗菌管理干预措施。目的确定所报告的抗生素过敏对住院患者的抗生素治疗的影响，并通过积极的抗菌管理干预措施来避免不必要的偏离首选抗生素治疗的情况。方法于2019年3月至5月之间，在荷兰的一家教学医院进行的一项干预研究中纳入了报告有抗生素过敏的住院患者。如果由于过敏标签而不必要地避免了首选的抗生素治疗，并且患者有资格进行药物挑战，则医生应接受培训并在电子病历中获得推荐。结果总共鉴定出492名报告抗生素过敏的患者，占558名住院患者。在93例中，抗生素过敏标签干扰了首选的抗生素治疗。这些患者中有68位有资格进行药物挑战，有42位患者受到挑战。在这些患者中有40名（95％）未观察到过敏反应，并给予了首选的抗生素治疗。接受药物攻击后，有两名（5％）患者出现了非严重的皮肤反应，并继续了另一种抗生素治疗方案。