The Australian journal of rural health · 2022
Assessment of the validity of the beta-lactam antibiotic allergy assessment tool for use in the rural context, QLD.
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English Karin R, Knight Kay, Radke Alexandra, Sammells Bethany, Walter Claire, Halliday Daniel
Аннотация
OBJECTIVE(S): The objective of the study was to validate a clinical aid to guide the assessment and management of a patient's listed beta-lactam antibiotic allergy for use in rural areas of Australia.
DESIGN: Rural generalists, pharmacists and junior doctors completed an online assessment of eight patient case studies using the tool.
SETTING: The study was conducted in the Southern Downs, QLD.
PARTICIPANTS: Twenty-seven rural generalists, nine pharmacists and eight junior doctors.
MAIN OUTCOME MEASURES: The sensitivity of the selected allergy phenotype and management option for each case study was calculated by profession and overall. Hazardous responses were reported by management category and profession.
RESULTS: The sensitivity overall for phenotype selection was 82.4% (95% CI, 78.0-86.2) and for management 88.1% (95% CI, 84.2-91.2). The sensitivity for phenotype selection was lower for junior doctors than other professions 73.4% (95% CI, 60.9-83.7), but did not reach statistical significance (p = 0.08). A total of 10/308 responses for management recommended the least restrictive option of direct delabelling or oral challenge, where the correct answer was skin prick testing or referral to an allergist.
CONCLUSION(S): With further education the tool could be a key component of increased antimicrobial stewardship in rural areas in Australia.
DESIGN: Rural generalists, pharmacists and junior doctors completed an online assessment of eight patient case studies using the tool.
SETTING: The study was conducted in the Southern Downs, QLD.
PARTICIPANTS: Twenty-seven rural generalists, nine pharmacists and eight junior doctors.
MAIN OUTCOME MEASURES: The sensitivity of the selected allergy phenotype and management option for each case study was calculated by profession and overall. Hazardous responses were reported by management category and profession.
RESULTS: The sensitivity overall for phenotype selection was 82.4% (95% CI, 78.0-86.2) and for management 88.1% (95% CI, 84.2-91.2). The sensitivity for phenotype selection was lower for junior doctors than other professions 73.4% (95% CI, 60.9-83.7), but did not reach statistical significance (p = 0.08). A total of 10/308 responses for management recommended the least restrictive option of direct delabelling or oral challenge, where the correct answer was skin prick testing or referral to an allergist.
CONCLUSION(S): With further education the tool could be a key component of increased antimicrobial stewardship in rural areas in Australia.