Evidence map›Paper›PMID 37061722›Full record

ArticleAntimicrobial resistance and infection control2023

An interdisciplinary student-led multifaceted intervention addressing overuse of broad-spectrum antibiotics for patients with penicillin allergies.

Bryana Banashefski, Philip Henson, Navindra David, Hui Ting Kok, Frans J Beerkens, Margaret Shyu, Anne S Linker, Surafel Tsega, Andrew Dunn, Risa Fuller

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Antimicrobial resistance and infection control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 29% of its field
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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
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

10 authors at 3 institutions in 1 country.

Bryana BanashefskiIcahn School of Medicine at Mount Sinai, 1468 Madison Ave, New York, NY, 10029, USA. bbanashefski@gmail.com.
Philip HensonIcahn School of Medicine at Mount Sinai, 1468 Madison Ave, New York, NY, 10029, USA.
Navindra DavidIcahn School of Medicine at Mount Sinai, 1468 Madison Ave, New York, NY, 10029, USA.
Hui Ting KokPhillips School of Nursing at Mount Sinai Beth Israel, New York, NY, USA.
Frans J BeerkensDivision of Hospital Medicine, Department of Medicine at Mount Sinai, New York, NY, USA.
Margaret ShyuDivision of Hospital Medicine, Department of Medicine at Mount Sinai, New York, NY, USA.
Anne S LinkerDivision of Hospital Medicine, Department of Medicine at Mount Sinai, New York, NY, USA.
Surafel TsegaDivision of Hospital Medicine, Department of Medicine at Mount Sinai, New York, NY, USA.
Andrew DunnDivision of Hospital Medicine, Department of Medicine at Mount Sinai, New York, NY, USA.
Risa FullerDivision of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Mount Sinai Hospital · USIcahn School of Medicine at Mount Sinai · USMount Sinai Beth Israel · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThough 15% of hospitalized patients have a documented penicillin (PCN) allergy, fewer than 1% have an IgE-mediated reaction that necessitates avoidance of β-lactam antibiotics.

objectiveOur interdisciplinary team of medical and nursing students led and executed a two-pronged quality improvement intervention to reduce prescribing of non-β-lactam antibiotics (NBLs) for patients with reported PCN allergies. To the best of our knowledge, this is the first multidisciplinary student-led intervention aimed at educating providers on low-risk penicillin allergy and encouraging best antibiotic prescribing practices. DESIGN AND

participantsThe intervention took place from June 2021 to February 2022. We developed and provided clinician education modules, including peer-to-peer information sharing and in-person small group discussions, as well as clinical decision support (CDS) strategies through the electronic medical record (EMR). The target population was attendings, residents, nurse practitioners, and physician assistants on the hospital medicine service at a large urban academic tertiary care center. We followed the SQUIRE 2.0 guidelines for reporting on quality improvement. MAIN MEASURES: Primary outcome measures included number of NBL prescriptions and use of nonspecific descriptors (e.g., "other" or "unknown") for PCN allergy reaction type, and were compared with a pre-intervention period. KEY

resultsThe percent of β-lactam prescriptions for patients with a PCN allergy after the intervention increased from 19 to 23% (p = 0.006). For patients with a low severity PCN allergy, the percent of β-lactam prescriptions increased from 20 to 28% (p = 0.001). There was a significant decrease in nonspecific PCN allergy reaction type from 23% in the pre-intervention period to 20% post-intervention (p = 0.012).

conclusionsAn intervention focused on educating prescribers and CDS strategies delivered through the EMR increased appropriate β-lactam prescribing for patients with a documented low-risk PCN allergy and reduced the use of nonspecific PCN allergy reaction type in EMR documentation.

Indexed as

Drug HypersensitivityHypersensitivityAnti-Bacterial Agentsbeta-LactamsHumansPenicillinsStudentsAnti-Bacterial Agentsbeta-LactamsPenicillinsPenicillin allergyQuality interventionβ-lactams

Identifiers

PMID37061722
PMCPMC10105531
OpenAlexW4365812797

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.