Honors College Thesis
 

Evaluating the Impact of Beta-Lactam Allergy Labels on Patient Outcomes in Bone Marrow Transplant Patients

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https://ir.library.oregonstate.edu/concern/honors_college_theses/gx41ms07p

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  • Background: Patients with a beta-lactam allergy noted in their medical record (i.e., allergy label) receive different antibiotics, even when an allergy is not truly present. Our objective was to evaluate allergy labels and their influence on patient outcomes among bone marrow transplant (BMT) recipients. Methods: We conducted a retrospective cohort study of adult inpatients with a BMT procedure April 2018-March 2020. Multivariable logistic regression was performed to measure independent effects of beta-lactam allergy labels on each 100-day outcome: mortality, ICU admission, rehospitalization, and intravenous antibiotic use. Patient eligibility for penicillin allergy testing/de-labeling was evaluated based on reaction history. Results: Among 358 patients, 75 (21%) had at least one beta-lactam allergy label at baseline. Mortality was higher in patients with an allergy label (14.7% vs 7.8%, p=0.067). Patients with a beta-lactam allergy label had an increased likelihood of receiving carbapenems (OR=6.27; 95% CI=2.81-13.98). All 59 patients with penicillin-class allergy labels were eligible for allergy testing/de-labeling. Conclusion: BMT patients with beta-lactam allergy labels were at increased odds of receiving carbapenems and experienced a non-significant trend towards increased mortality. As no study patients had evidence of clinically-relevant allergies, implementation of allergy de-labeling programs may help optimize antibiotic prescribing and outcomes in BMT patients.
  • Keywords: Allergy, allergic reaction, beta-lactam, penicillin, cephalosporin, carbapenem, antibiotic stewardship, bone marrow transplant, hematologic malignancy.
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  • Pending Publication
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  • 2022-12-02 to 2023-07-03

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