. Author manuscript; available in PMC: 2020 Jul 1.

Published in final edited form as: Ann Allergy Asthma Immunol. 2019 Apr 19;123(1):16–34. doi: 10.1016/j.anai.2019.04.009

Table 5.

Specialist-based comprehensive BL allergy pathways in acute care

Study	Location	Setting	Patient Selection	Study Design	Type of Intervention	Outcome(s) measured
Banks (2015)⁵² and Ressner (2016)⁵³	Bethesda, MD, US	Military Medical Center	General medicine or intensive care unit patients with penicillin allergy	Conceptual framework	Automatic AI consultation for triage of evaluations that should be inpatient vs outpatient (Figure 3)	Not applicable
Trubiano (2017)⁵⁴	Melbourne, Australia	2 tertiary care referral centers	Referrals of patients with ABX allergies from clinical specialists and adverse drug reaction committees. All ABX allergies considered but most patients had penicillin (54%) or cephalosporin (18%) allergy	Prospective observational study of 141 patients referred and 118 patients completing testing.	Comprehensive ABX allergy assessments carried out by dedicated pharmacist and physician: ABX skin testing, patch testing, challenge doses, consultation guidance, allergy label removals	Alternative ABX use	Decrease usage of glycopeptide, carbapenem, lincosamide, and fluoroquinolone
						BL use	Increase in penicillin (7% to 23%) and 1^st/2nd generation cephalosporins (11% vs 18%)
						ABX appropriateness	Guideline-preferred therapy increased from 12-18% to 83%
						Allergy documentation	Revised allergy labels (94%), removed allergy labels (83%), including patients with more than 1 ABX allergy label removed (27%)

Abbreviations: AI, allergy/immunology; ABX, antibiotics; BL, beta-lactam