Assessment of the validity of the beta-lactam antibiotic allergy assessment tool for use in the rural context, QLD.

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.