ArticleThe journal of allergy and clinical immunology. In practice2023
Digital Antibiotic Allergy Decision Support Tool Improves Management of β-Lactam Allergies.
Article in The journal of allergy and clinical immunology. In practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The trial behind it
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Who cites it
3 citing papers in PubMed.
- Developing and disseminating an electronic penicillin allergy de-labelling tool using the model for improvement framework.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2024Article
- Is the Anamnesis Enough to De-Label Patients with Reported Beta-Lactam Allergy?Journal of clinical medicine · 2024Article
- Approach for delabeling beta-lactam allergy in children.Frontiers in allergy · 2023Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundFrontline providers frequently make time-sensitive antibiotic choices, but many feel poorly equipped to handle antibiotic allergies.
objectiveWe hypothesized that a digital decision support tool could improve antibiotic selection and confidence when managing β-lactam allergies.
methodsA digital decision support tool was designed to guide non-allergist providers in managing patients with β-lactam allergy labels. Non-allergists were asked to make decisions in clinical test cases without the tool, and then with it. These decisions were compared using paired t tests. Users also completed surveys assessing their confidence in managing antibiotic allergies.
resultsThe tool's algorithm was validated by confirming its recommendations aligned with that of five allergists. Non-allergist providers (n = 102) made antibiotic management decisions in test cases, both with and without the tool. Use of the tool increased the proportion of correct decisions from 0.41 to 0.67, a difference of 0.26 (95% CI, 0.22-0.30; P < .001). Users were more likely to give full-dose antibiotics in low-risk situations, give challenge doses in medium-risk situations, and avoid the antibiotic and/or consult allergy departments in high-risk situations. A total of 98 users (96%) said the tool would increase their confidence when choosing antibiotics for patients with allergies.
conclusionsA point-of-care clinical decision tool provides allergist-designed guidance for non-allergists and is a scalable system for addressing antibiotic allergies, irrespective of allergist availability. This tool encouraged appropriate antibiotic use in low- and medium-risk situations and increased caution in high-risk situations. A digital support tool should be considered in quality improvement and antibiotic stewardship efforts.
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