Rochester, NY—Pharmacists are more knowledgeable about penicillin allergies than inpatient physicians, according to a new study calling for more education on the topic.

The report, published in the Annals of Allergy, Asthma and Immunology, was based on 276 surveys filled out by nonallergist physicians, physician assistants, nurse practitioners and pharmacists at Rochester, New York, Regional Health.

Results indicate that more than 80% of the hospital-based physicians surveyed in their system were aware that allergy testing is recommended for patients who report a penicillin allergy, but most had never done so or had only referred one patient a year.

The pharmacists surveyed, however, had more knowledge, the Rochester Regional Health researchers point out.  

“We were not surprised pharmacists understood the course of penicillin allergy better than other clinicians, given more extensive pharmacology education,” notes lead author Mary Staicu, PharmD, an infectious-disease pharmacist. “Of those surveyed, 78% of pharmacists knew penicillin allergy can resolve over time. Only 55% of the remaining respondents (non-allergist physicians, physician assistants, and nurse practitioners) did.”

Background information in the article also discussed limited awareness among the physicians, most of whom had been in practice for more than a decade, of the prevalence of reported penicillin allergies in patients who never have been tested.

While 10% to 20% of Americans believe they have a penicillin allergy, study authors cite previous research finding only about 10% are penicillin-allergic. Furthermore, among that relatively small number of people with verified allergy to penicillin, only about 20% are still allergic 10 years after their initial adverse reaction.

“Our research found a poor understanding of penicillin allergy among non-allergists,” explained co-author Allison Ramsey, MD, an allergist. “This was not a surprising finding given the clinical experience of most allergists, but it does provide an excellent opportunity for education on the topic—not just for patients, but for all health care professionals.”

One problem, the researchers point out, is that second-line antibiotics often are used in patients identified as penicillin allergic, and those are pricier and tend to have increased side effects.

“More than 90% of people labeled with a penicillin allergy can tolerate penicillin-based antibiotics,” Ramsey said. “Our survey showed only 30% of physician survey respondents knew that. It’s important that doctors understand the importance of confirming penicillin allergy. But it’s even more important that those who carry the label be educated and tested.”

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