Educational Resources

Penicillin Allergy Assessment Tool Kit

An estimated 10% of the US population reports having an allergic reaction to a penicillin-class antibiotic. However, when evaluated, fewer than 1% are truly allergic. Broad-spectrum antibiotics are a common alternative to penicillins and are associated with more side effects, higher healthcare costs, and antimicrobial resistance.

These allergies can be evaluated by a trained pharmacist or physician. The tool kit below has been created to educate patients and their caregivers and to train healthcare providers on how to proactively assess penicillin allergies. Removing the allergy from medical records of patients who are not truly allergic to penicillins is an important stewardship tool that decreases unnecessary use of broad-spectrum antibiotics.

The tool kit includes:

• • A visual big-picture overview of the allergy assessment process and associated resources
  • Penicillin Allergy Assessment Presentation: This 20-minute presentation provides background on penicillin allergies, healthcare outcomes associated penicillin allergies, and discusses how to conduct assessments using an Epic SmartPhrase.
    • Test your knowledge: Patient Cases
  • Risk Stratification Chart assists with determining patient’s allergy risk based on their past allergic history
  • NIAID/FAAN Anaphylaxis Risk Chart: aids healthcare providers in identifying an anaphylactic reaction appropriately
  • Patient Education Materials
    • Patient Educational Fact Sheet describes why allergy assessment matters and its benefits
    • ¿Es alérgico a la penicilina? Información para pacientes
    • CDC Educational Fact Sheet: Is It Really a Penicillin Allergy? Evaluation and Diagnosis of Penicillin Allergy for Healthcare Professionals
    • Wallet Card: Fill and print for patients who have been de-labeled through your assessment as a reminder that they are no longer allergic.

The Penicillin Allergy Assessment Tool Kit is a collaboration of the UNC Medical Center’s Carolina Antimicrobial Stewardship Program, the UNC Division of Rheumatology, Allergy & Immunology, and the UNC Institute for Healthcare Quality Improvement. If you are interested in incorporating penicillin allergy assessments into your practice, please contact Mildred Kwan or Renae Boerneke for more information.

Information for Patients & Caregivers

• Antimicrobial Stewardship: A Patient’s Guide (2021) is a resource for patients and caregivers describing the important role of stewardship in patient care
• Patient and Healthcare Provider Information on antibiotic prescribing for use in doctors’ offices, includes selected resources in Spanish, French, Chinese, Korean, Vietnamese, Portuguese, and English
• For Parents of Young Children includes information on appropriate antibiotic prescribing for common childhood illnesses
• WHO Global Antimicrobial Resistance Fact Sheet (2018)  also includes links to the global action plan (2015) and other resources
• CDC’s U.S. Antimicrobial Resistance Prevention Fact Sheet (2019)

Reports

• The National Quality Forum‘s Antimicrobial Stewardship Playbook (2016) provides real-world ideas for application of the CDC’s Core Elements (see below)
• Tools and resources for implementing antimicrobial stewardship from the Society for Healthcare Epidemiology of America (SHEA)
• Resources on antimicrobial stewardship and resistance from the Infectious Diseases Society of America

The US Centers for Disease Control and Prevention and the Agency for Healthcare Quality and Research are two of several agencies of the U.S. Department of Health and Human Services charged with leading national efforts on antimicrobial use and resistance. Their websites provide a wealth of resources and information, including:

• Core Elements for Hospital Antimicrobial Stewardship Programs (2019) define structural and procedural components that are associated with successful stewardship programs. The site also includes resources tailored for small & critical access facilities , outpatient settings, nursing homes, and resource-limited facilities
• Antibiotic Resistance Threats in the United States, 2019 includes the latest national death and infection estimates that underscore the continued threat of antibiotic resistance in the U.S.
• CDC’s Antibiotic Stewardship Training Series (free with account creation; C.E. available) is a nine-module, interactive, web-based training designed to help clinicians optimize antibiotic use to combat antibiotic resistance and improve healthcare quality and patient safety.
• Agency for Healthcare Research and Quality’s Safety Program for Improving Antibiotic Use aims to support clinicians apply the Comprehensive Unit-based Safety Program (CUSP) method to improve antibiotic stewardship by selecting the optimal antibiotic regimens, routes of administration, and durations
• The AHRQ developed an Antibiotic Stewardship Toolkit for acute care hospitals (2019), with additional toolkits in development for long-term care and ambulatory care practices (expected in 2021).

Infectious Diseases Fellowships

Global & National Campaigns

• 

  World Antimicrobial Awareness Week takes place each November. Resources include a customizable poster-maker (scroll to bottom)  and other materials to amplify campaign messages globally.

• The CDC is the U.S. lead agency for World Antimicrobial Awareness Week and provides a partner tool kit to make participation easier and coordinated across the U.S.

Data

• Antibiotic Resistance & Patient Safety Portal (formerly the Patient Safety Portal) allows users to explore and visual data on antibiotic resistance and healthcare-associated infections
• CDC’s National Healthcare Safety Network (NHSN) publishes reports from its data on topics such as antimicrobial use and resistance, including antimicrobial-resistance pathogens associated with healthcare-associated infections