Allergy Delabeling in Antibiotic Stewardship - Intervention

The RENEW clinical intervention is designed to evaluate the impact of a comprehensive beta lactam allergy delabeling intervention on clinical outcomes among patients hospitalized with a hematologic malignancy (HM).

HM patients are at a high risk of infection-related complications but are limited to antibiotic therapy based on self-reported allergies.

Beta-lactam (BL) antibiotics are a preferred treatment option for many bacterial infections, however, these antibiotics remain inaccessible as a treatment option for patients with a self-reported BL allergy. In the hospital setting, BL allergies are documented in the electronic medical record in up to 20% of hospitalized patients. Prior studies have shown that 90% of the patients for whom these allergies are reported are able to tolerate penicillin (PCN) or other BLs. Delabeling strategies to correctly identify true BL allergies in the general hospital population have proven successful. However, these studies have not been conducted among patients diagnosed with a hematological malignancy. The investigators propose to test the impact of a pharmacist-led BL allergy delabeling intervention on clinical outcomes and antibiotic use in hospitalized patients with HM.

The intervention is a multi-step PCN delabeling strategy that includes 1) an assessment of the participant's BL allergy by a clinical pharmacist based on a detailed medical history; 2) assignment of additional allergy testing based on the RENEW-IN algorithm; and 3) delabeling of the allergy within the participants electronic medical record if appropriate.

• Clinical Cultures positive for multi-drug resistant organisms [Срок оценки: From baseline enrollment to end of index index hospitalization or death, up to 36 months]
• Clinical Cultures positive for Clostridioides difficile infection [Срок оценки: From baseline enrollment to end of index index hospitalization or death, up to 36 months]
• Clinical Cultures positive for Health-care Associated Infections (HAIs) [Срок оценки: From baseline enrollment to end of index index hospitalization or death, up to 36 months]
• Need for ICU transfer [Срок оценки: From baseline enrollment to end of index index hospitalization or death, up to 36 months]
• ICU length of stay [Срок оценки: From baseline enrollment to end of index index hospitalization or death, up to 36 months]
• Patient Disposition [Срок оценки: From baseline enrollment to end of index index hospitalization or death, up to 36 months]