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Post by Wai-Ling Lo on Jul 31, 2019 10:20:08 GMT -5
1. In practice, do you routinely question pcn allergic patients as to type of reaction, timing of reaction, etc.
Yes, I always assess the PCN allergy in details so that I can determine whether it's true anaphylaxis reaction or not. Also the information is used to discuss / 'convince' the surgeon that it is appropriate to use cephalosporin as the antibiotics coverage.
2. Do the results of the studies cause you to rethink how you will administer antibiotics in the future?
Like most others, I have been changed my practice too and use Ancef as the first line antibiotic if there is no true contraindication to give beta lactam antibiotics. 50% increased in SSI with second line antibiotics is significant, therefore, we have to reinforce this practice.
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Post by Jennifer Hannon on Jul 31, 2019 11:49:01 GMT -5
1) I ask PCN allergic patients about the symptoms they've experienced and the start/duration/severity of the symptoms.
2) This article helped solidify Ancef use. 50% increased odds is definitely significant. I have still given Ancef to All:PCN patients as the evidence with cross-sensitivity with Keflex and Ancef is still reported to be low.
-Jen Hannon
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Post by Kim Hall on Jul 31, 2019 17:40:04 GMT -5
1. I routinely ask my patients about their PCN allergy in order to advocate for the use of Ancef
2. The results of this study help me to understand true contraindications and make me more confident in administering Ancef.
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Post by Dahlia Rouchon on Aug 1, 2019 17:31:23 GMT -5
1. Yes, I do ask what their reaction to PCN is. If there is airway compromise or elevated hives and no cephalosporin has been used since, I would refrain from using PCN.
2. In regards to the article, I would agree that continued inquiry is indicated to specify exactly what the reaction is and lean towards using PCN when indicated and per patient history vs. using another option.
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Post by Patricia Brissett on Aug 6, 2019 14:45:11 GMT -5
1: I continue to aggressively inquire more about PCN allergy especially with the SCIP protocols. After a near death incident years ago, where patient stated allergy to PCN as itching and we agreed to test dose after induction. Lo and behold, I was dealing with severe hypotension -> anaphylaxis after 100mg of Ancef with patient ending up in ICU.
2: Needless to say, the article has not changed my practice as I had already made clinical changes. Appreciate the article
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Post by Kristen Horsman on Aug 9, 2019 7:58:30 GMT -5
1. As a result of the change in the PCN allergy algorithm for which antibiotic to use, I now ask everyone with a PCN allergy what their reaction was. I inquire specifically about rashes and I also ask if they have ever had any cephalosporins without issue Ie: Keflex.
2. I have already altered how I administer antibiotics and consistently have conversations with surgeons about appropriate antibiotic use.
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Post by abosabi on Oct 7, 2019 7:16:42 GMT -5
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