Table 1.
Hospital Access to Penicillin Allergy Assessment Resources
| All (N = 121) | Academic Medical Centers (n = 55) | Community Hospitals (n = 66) | |
|---|---|---|---|
| Allergy specialist access | |||
| Allergy specialist available for inpatient consultation | 53 (44) | 44 (80)a | 9 (14)a |
| Allergist on antibiotic stewardship team | 4 (3) | 3 (5) | 1 (2) |
| Time to see allergist for inpatientsb | |||
| Within a few hours | 5 (9) | 5 (11) | 0 (0) |
| More than a few hours but within the day | 22 (42) | 20 (45) | 2 (22) |
| More than 1 day but within a few days | 22 (42) | 15 (34) | 7 (78) |
| Penicillin skin testing access | |||
| Inpatient skin testing available | 47 (39) | 35 (63)a | 12 (18)a |
| Other skin testing locations | |||
| Outpatient | 38 (81) | 31 (89)c | 7 (58)c |
| Emergency | 3 (6) | 2 (6) | 1 (8) |
| Preoperative area | 1 (2) | 1 (3) | 0 (0) |
| Skin testing performers | |||
| Allergy/immunology medical doctors | 33 (70) | 27 (77) | 6 (50) |
| Infectious diseases medical doctorsb | 7 (15) | 6 (17) | 1 (8) |
| Pharmacistc | 6 (13) | 5 (14) | 1 (8) |
| Nurse | 4 (9) | 2 (6) | 2 (17) |
| Pediatrics | 1 (2) | 1 (3) | 0 (0) |
| Otherd | 4 (9) | 2 (6) | 2 (17) |
| Skin testing reagents used | |||
| Benzyl penicilloyl-polylysine (major determinant) | 31 (66) | 23 (66) | 8 (67) |
| Penicillin G | 29 (62) | 20 (57) | 9 (75) |
| Cephalosporins | 9 (19) | 8 (23) | 1 (8) |
| Ampicillin | 8 (17) | 5 (14) | 3 (25) |
| Amoxicillin | 3 (6) | 3 (9) | 0 (0) |
| Minor determinant(s) | 2 (4) | 1 (3) | 1 (8) |
| Unknown | 7 (15) | 6 (17) | 1 (8) |
| Other penicillin allergy assessment resources | |||
| Drug challenge available | 62 (51) | 41 (75)a | 21 (32)a |
| Antibiotic desensitization available | 100 (83) | 54 (98)a | 46 (70)a |
| Guideline for prescribing antibiotics to patients reporting penicillin or B-lactam allergies (approved or in development) | 57 (47) | 31 (56)e | 26 (39)e |
Data are presented as n (%).
aChi-square, P < .001.
bFour academic medical centers responded “unknown”.
cChi-square, P = .035.
d“Other” includes critical care providers, intensive care units, infectious disease pharmacy residents, and trained nurse practitioners and physician assistants.
eChi-square, P = .07.