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Penicillin Allergy Testing: An Outpatient Nurse-Driven Program for Patients With Cancer

Sejal Morjaria
Faye Inumerables
Dhruvkumar Patel
Nina Cohen
Susan Seo
Susan Posthumus
Steven C. Martin
Anna Kaltsas
Shawna Lee
Nicole Boucher
Erica Fischer-Cartlidge
CJON 2021, 25(2), 143-150 DOI: 10.1188/21.CJON.143-150

Background: Penicillin allergy testing (PAT) can decrease the use of unnecessary antibiotics by clarifying who is truly allergic.

Objectives: This article describes the development and implementation of an oncology outpatient nurse-driven PAT program.

Methods: A nurse-driven program, initiated with allergy screening at the first encounter, was designed to identify patients with oncologic diagnoses eligible for PAT. Once verified eligible, patients undergo a three-step testing process (scratch test, intradermal injection, and IV challenge dose) administered by the infusion nurse.

Findings: From November 2018 to December 2019, 82 outpatients with reported penicillin allergies were screened; 90% were eligible for PAT, and 97% of patients tested were negative for penicillin allergy. A significant reduction in aztreonam use among patients admitted for hematopoietic stem cell transplantation was also noted as compared to before PAT was offered.

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