Evidence map›Paper›PMID 34223136›Full record

ArticleJAC-antimicrobial resistance2021

Implementing a new antibiotic allergy protocol in clinical practice: well-trusted but not used.

P Hanssen, C Nieuwhof, S van Mens, A van de Plas, K Horstman

Abstract read
In one paragraph

Article in JAC-antimicrobial resistance, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

P HanssenFaculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
C NieuwhofDepartment of Allergology and Clinical Immunology, Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
S van MensDepartment of Medical Microbiology, Maastricht University Medical Center, Maastricht, The Netherlands.
A van de PlasDepartment of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, The Netherlands.
K HorstmanDepartment of Health, Ethics, and Society, Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSuboptimal antibiotic prescriptions in patients with an antibiotic allergy label lead to increased incidence of adverse events and antimicrobial resistance (AMR). An antibiotic allergy protocol was developed in a Dutch academic hospital guiding optimal and safe antibiotic use in potentially penicillin-allergic patients. Informed by previous studies of implementation processes in clinical care, we studied the implementation of this protocol.

methodsMedical professionals in the Departments of Surgery, Internal Medicine, and Pulmonary Care were interviewed. Additionally, focus groups were conducted in Internal Medicine and Pulmonary Care to validate the outcomes of the interviews.

resultsDissemination of the protocol via the regular online hospital-wide guidance system did not have a significant impact on the knowledge about or use of the protocol. If healthcare professionals found the protocol, they thought it was valuable and expressed trust in the expertise embodied in it. However, its use in practice was rather minimal. Interviewees doubted the accuracy of the patient's histories about their previous adverse drug reactions, and/or the information in their medical records and concluded that adherence to the expert guideline was needlessly risky. They felt the acute allergic reaction risk for a patient outweighed the risk of suboptimal therapy or future AMR.

conclusionsFor successful implementation and dissemination of the protocol, the accessibility of the protocol, the information about the actual risks of following the protocol and the registration of allergic history should be improved. However, whether this actually results in improvement also depends on changes in the hospital culture and organization.

Identifiers

PMID34223136
PMCPMC8210085

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