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These types of culture results always send a chill down my spine...
#IDtwitter#AntibioticResistancepic.twitter.com/lppQ6FGStN
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Jeff Pearson proslijedio/la je Tweet
SAVE THE DATE! Thursday 2/13 from 8-9PM EST
@accpinfdprn and@accpcritprn will be teaming up for a pro-con debate on#procalcitonin, we hope you will join us in this twitter debate! Which side are you on?
#procaldebate
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What other notable allergy publications did I miss from 2019? I can’t catch them all, so let me know and I’ll be sure to give a shout-out! And don't miss the live webinar tonight at 5:30 EST! https://www.mashp.org/events/EventDetails.aspx?id=1310655 …
#PCNallergy 8/8Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
And lastly,
@BSACandJAC published an RPh-led allergy de-labelling service in Australia that showed this strategy to be safe and effective https://www.ncbi.nlm.nih.gov/pubmed/30753497#PCNallergy 7/8Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
And
@theannals published findings from an RPh-led beta-lactam allergy interview that reduced fluoroquinolone prescribing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630467/ …@ewood_1875#PCNallergy 6/8pic.twitter.com/WhQE8Dmw96
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Even without skin testing, pharmacists can make a difference though!
@BSACandJAC published a positive study focused on RPh-led#PCNallergy de-labelling ward rounds https://www.ncbi.nlm.nih.gov/pubmed/30869124@mishadevchand@TrubianoJason#PCNallergy 5/8pic.twitter.com/qTHWMElHks
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A prospective pilot also in
@AJHPOfficial showed the successful implementation of#PCNallergy skin testing in a community hospital setting https://www.ncbi.nlm.nih.gov/pubmed/31677260#PCNallergy 4/8Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
This guide also had the most comprehensive review of pharmacy state regulations concerning
#PCNallergy skin testing to-date. At least 18 states allow RPhs to administer skin tests. If a future update to the table is made, Massachusetts is unfortunately not one of them (yet) 3/8pic.twitter.com/gnUjmUd5Am
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An excellent guide to implementing
#PCNallergy skin testing was published in@AJHPOfficial https://www.ncbi.nlm.nih.gov/pubmed/30689753@blandman19@bbookstaver_usc@emilylheil@bruce_m_jones@julie_justo@marylynnstaicu@NPT_PharmD@NuwavePharm 2/8pic.twitter.com/T8AWx6vPxN
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PCN Allergies, day 7: I’ll end the week of
#PCNallergy links with a shout-out to all the awesome work done by pharmacists in this space this past year! See thread below for 5 RPh-led studies from 2019 & tune in tonight for the full presentation https://www.mashp.org/events/EventDetails.aspx?id=1310655 … 1/8pic.twitter.com/3AJBLzuRFQ
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Which goes hand-in-hand with this brief recent literature review in
@BSACandJAC from September that proposes direct oral amoxicillin challenges in low-risk patients labelled with a#PCNallergy https://www.ncbi.nlm.nih.gov/pubmed/31167024 pic.twitter.com/DwW5I680Ij
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Also published this past year in
@amjmed in October, a meta-analysis of over 5000 patients with a reported#PCNallergy showed that 94.4% of patients tolerated a systemic dose of a penicillin (either through graded challenge or test dose procedure) https://www.ncbi.nlm.nih.gov/pubmed/31647915 pic.twitter.com/l9rtTGhuRw
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PCN Allergies, day 6: skin testing for
#PCNallergy isn't necessary for most patients. This RCT from@JACIInPractice in June showed that direct oral amoxicillin challenges were safe and effective to rule out allergy in low-risk patients https://www.ncbi.nlm.nih.gov/pubmed/31170542@MAPharmacistspic.twitter.com/g5jxcVTrKG
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This new skin test kit could provide a one-stop shop for
#PCNallergy skin testing. But until it is reviewed by the FDA, an oral amoxicilin challenge can be given to skin test-negative patients to improve the NPV of the assessment from ~95% to close to 100% 3/3Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
The only FDA-approved skin test reagent is Pre-Pen, which provides the major determinant penicilloyl polylysine. Minor determinants are used off-label, and IV amoxicillin isn't currently available in the US to administer as a skin test
#PCNallergy 2/3Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
PCN Allergies, day 5: The Penicillin Skin Test Kit, in addition to major and minor allergenic determinants, also contains an amoxicillin skin test. In this prospective study, it had a negative predictive value of 98% https://www.ncbi.nlm.nih.gov/pubmed/30878711
#PCNallergy@MAPharmacists 1/3Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
PCN Allergies, day 4: A meta-analysis looked at cross-reactivity potential in
#PCNallergy patients. Cross-reactivity varied: 16.5% chance for cephalosporins with similar R1 side chains, 2.1% for cephs with different side chains, and 0.9% for carbapenems https://www.ncbi.nlm.nih.gov/pubmed/31170539 pic.twitter.com/qOI2o8764L
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PCN Allergy Study, day 3: this retrospective cohort (https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/selfreported-betalactam-allergy-and-the-risk-of-surgical-site-infection-a-retrospective-cohort-study/90C7DEDA4A42F23149EDEFFED6DB67EA …) showed an increase in risk of surgical site infection in
#PCNallergy patients (OR 1.61), very similar to previous findings by@KimberlyBlumen1 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850334/ …)@MAPharmacistspic.twitter.com/kvw0jgyHQa
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Also published was this prevalence study from the UK. With 2.3 million patients, they found a
#PCNallergy rate of 5.9%, which increased risk of antibiotic re-prescribing (RR 1.32), MRSA infection/colonization (RR 1.9), and mortality within a year (RR 1.08) https://www.ncbi.nlm.nih.gov/pubmed/31225607 pic.twitter.com/mZMXDL3cXG
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PCN Allergy Study, day 2: an enormous population-based data set was published by
@EricMacyMD and@aboutKP. ~6 million PCN courses, only 25 cases of anaphylaxis (~1 in 240,000 exposures), which was only 0.067% of the new#PCNallergy reports https://www.ncbi.nlm.nih.gov/pubmed/31821919@MAPharmacistspic.twitter.com/rkboAdU5Hh
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