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10.1016/j.jaci.2017.02.005 http://scihub22266oqcxt.onion/10.1016/j.jaci.2017.02.005 C5496780!5496780!28254470     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       J+Allergy+Clin+Immunol 2017 ; 140 (1): 154-161.e6 Nephropedia Template TP {{tp|p=28254470|t=2017. Tackling inpatient penicillin allergies: Assessing tools for antimicrobial stewardship |pdf=|usr=}}{{28254470}} gab.com Text Tackling inpatient penicillin allergies: Assessing tools for antimicrobial stewardship JO: J Allergy Clin Immunol http://www.kidney.de/pget.php?&tw=1&pmid=28254470 #FOAvip Background: Reported penicillin allergy rarely reflects penicillin intolerance. Failure to address inpatient penicillin allergies results in more broad-spectrum antibiotic use, treatment failures, and adverse drug events. Objective: We aimed to determine the optimal approach to penicillin allergies among medical inpatients. Methods: We evaluated internal medicine inpatients reporting penicillin allergy in three periods: (1) standard of care (SOC), (2) penicillin skin testing (ST), and (3) computerized guideline application with decision support (APP). The primary outcome was use of a penicillin or cephalosporin, comparing interventions to SOC using multivariable logistic regression. Results: There were 625 patients: SOC 148, ST 278, and APP 199. Of 278 ST patients, 179 (64%) were skin test eligible; 43 (24%) received testing and none were allergic. In the APP period, there were 292 unique website views; 112 users (38%) completed clinical decision support. While ST period patients did not have an increased odds of penicillin or cephalosporin use overall (aOR 1.3 [95% CI 0.8, 2.0]), we observed a significant increased odds of penicillin or cephalosporin use overall in the APP period (aOR 1.8 [95% CI 1.1, 2.9]), and in a per protocol analysis of the skin tested subset (aOR 5.7 [95% CI 2.6, 12.5]). Conclusions: Both the computerized guideline with decision support and penicillin skin testing ? when completed ? increased use of penicillin and cephalosporin antibiotics among inpatients reporting penicillin allergy. While the skin tested subset showed an almost 6-fold impact, the computerized guideline significantly increased penicillin or cephalosporin use overall nearly 2-fold and was readily implemented. Twit Text FOAVip Tackling inpatient penicillin allergies: Assessing tools for antimicrobial stewardship ????J Allergy Clin Immunol http://www.kidney.de/pget.php?&tw=1&pmid=28254470 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=28254470 #FOAvip English Wikipedia <ref>{{Cite pmid|28254470}}</ref> Tackling inpatient penicillin allergies: Assessing tools for antimicrobial stewardship #MMPMID28254470 Blumenthal KG; Wickner PG; Hurwitz S; Pricco N; Nee AE; Laskowski K; Shenoy ES; Walensky RP J Allergy Clin Immunol 2017[Jul]; 140 (1): 154-161.e6 PMID28254470show ga Background: Reported penicillin allergy rarely reflects penicillin intolerance. Failure to address inpatient penicillin allergies results in more broad-spectrum antibiotic use, treatment failures, and adverse drug events. Objective: We aimed to determine the optimal approach to penicillin allergies among medical inpatients. Methods: We evaluated internal medicine inpatients reporting penicillin allergy in three periods: (1) standard of care (SOC), (2) penicillin skin testing (ST), and (3) computerized guideline application with decision support (APP). The primary outcome was use of a penicillin or cephalosporin, comparing interventions to SOC using multivariable logistic regression. Results: There were 625 patients: SOC 148, ST 278, and APP 199. Of 278 ST patients, 179 (64%) were skin test eligible; 43 (24%) received testing and none were allergic. In the APP period, there were 292 unique website views; 112 users (38%) completed clinical decision support. While ST period patients did not have an increased odds of penicillin or cephalosporin use overall (aOR 1.3 [95% CI 0.8, 2.0]), we observed a significant increased odds of penicillin or cephalosporin use overall in the APP period (aOR 1.8 [95% CI 1.1, 2.9]), and in a per protocol analysis of the skin tested subset (aOR 5.7 [95% CI 2.6, 12.5]). Conclusions: Both the computerized guideline with decision support and penicillin skin testing ? when completed ? increased use of penicillin and cephalosporin antibiotics among inpatients reporting penicillin allergy. While the skin tested subset showed an almost 6-fold impact, the computerized guideline significantly increased penicillin or cephalosporin use overall nearly 2-fold and was readily implemented. äTackling inpatient penicillin allergies: Assessing tools for antimicro(epmc).pdf DeepDyve Pubget Overpricing