Antibiotic resistance is a clinical and public health crisis. The misuse of antibiotics is a primary driver of this issue and antibiotic stewardship programs are challenged to change clinical practice patterns in response to this growing problem. Penicillin allergy skin testing is a novel approach to address the misuse of antibiotics by optimizing antibiotic utilization and is now included in the CDC's Get Smart Program materials, IDSA Stewardship Guidelines, SHEA Guidelines, and is endorsed by the AAAAI.

Publications

Pocket Playbook for the Core Elements of Antimicrobial Stewardship

This pocket playbook is intended to provide a practical overview of stewardship implementation with a focus on penicillin allergy skin testing.

IDSA: New Antimicrobial Stewardship Guideline 2016

The new Antibiotic Stewardship Guidelines focus on practical advice for implementation

CDC: Core Elements of Hospital Antibiotic Stewardship Programs

This document summarizes core elements of successful hospital Antibiotic Stewardship Programs. It complements existing guidelines on ASPs from organizations including the Infectious Diseases Society of America.

Antibiotic Resistance Facts

By some estimates, up to half of all hospitalized patients in the US receive antibiotics and up to half of antimicrobial use may be inappropriate.3 There is a causal relationship between inappropriate antimicrobial use and resistance; changes in antimicrobial use lead to parallel changes in the prevalence of resistance.4

  • Since the discovery of penicillin, more than 100 antibiotic compounds have been introduced. But almost as soon as they were given to patients, scientists began finding evidence that disease-causing bacteria were developing resistance to these new wonder drugs.3
  • The number of antibiotic resistant bacteria continues to increase every year.3
  • The number of antibiotics in the approval pipeline continues to decrease every year.3

How can we better use the antibiotics we currently have?

Core Elements of Antibiotic Stewardship4

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A growing body of evidence demonstrates that hospital based programs dedicated to improving antibiotic use, commonly referred to as “Antibiotic Stewardship Programs (ASPs),” can both optimize the treatment of infections and reduce adverse events associated with antibiotic use.6 Following the example set by the CDC “Get Smart for Healthcare” Campaign6, we recommend implementing penicillin allergy testing using the Core Elements of Hospital Antibiotic Stewardship Programs.

The Core Elements complement existing guidelines on ASPs from organizations including the Infectious Diseases Society of America in conjunction with the Society for Healthcare Epidemiology of America, American Society of Health System Pharmacists, and The Joint Commission.6,9,10

Take action in support of optimal antibiotic use with Penicillin Skin Testing.

Why Penicillin Allergy Skin Testing?

Instructions for Supply Management and Test Preparation

Instructions for Conducting and Interpreting Penicillin Allergy Skin Testing

Contact ALK at prepen@alk.net or
1-800-325-7354 to learn how ALK can
help you impact antibiotic treatment
through penicillin allergy testing.

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References

  • 1Owens, RC Jr., Fraser GL, Stogsdill P et al. Antimicrobial Stewardship Programs as a Means to Optimize Antimicrobial Use. Insights from the Society of Infectious Disease Pharmacists. Pharmacotherapy. 2004;24:896-908.
  • 2Dellit, TH, Owens, RC, McGowan JE, Jr et al. Infectious Disease Society of America and the Society for Healthcare Epidmiology of America Guidelines for Developing Institutional Programs to Enhance Antimicrobial Stewardship. Clin Infect Dis. 2007;44-150-77.
  • 3Healy, Melissa. LA Times. A Slow Catastrophe Unfolds as the Golden Era of Antibiotics Comes to an End. July 11, 2016.
  • 4Dellit, TH, Owens, RC, McGowan JE, Jr et al. Infectious Disease Society of America and the Society for Healthcare Epidmiology of America Guidelines for Developing Institutional Programs to Enhance Antimicrobial Stewardship. Clin Infect Dis. 2007;44-150-77.
  • 5Blumenthal, Kimberly. Fortune Favors the Bold: Give a Beta-Lactam! Clinical infectious Diseases Advance Access. 2016 July.
  • 6Centers for Disease Control (CDC) Get smart for healthcare website. http://www.cdc.gov/getsmart/healthcare/. [Cited 2016 Apr].
  • 7Macy, Eric. Healthcare Use and Serious Infection Prevalence Associated with Penicillin "Allergy" in Hospitalized Patients: A Cohort Study. American Academy of Allergy, Asthma & Immunology. 2013.
  • 8Healy, Melissa. LA Times. A Slow Catastrophe Unfolds as the Golden Era of Antibiotics Comes to an End. July 11, 2016.
  • 9The Joint Commission. Antimicrobial Stewardship Toolkit. 2013; http://store.jcrinc.com/antimicrobial-stewardship-toolkit/.
  • 10 American Society of Health-System Pharmacists. Implementing Antimicrobial Stewardship Programs in Health Systems: An Interprofessional Team Approach. 2013; www.leadstewardship.org.