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A Practical Guide for Managing Antibiotic Allergies in the Emergency Department

Chastain, Daniel B. PharmD, BCIDP, AAHIVP; Steele, Gregory M. RN, MSN, FNP-BC; Sams, Joeanna I. PharmD, BCPS

Section Editor(s): Weant, Kyle A. PharmD, BCPS, FCCP; Column Editor

doi: 10.1097/TME.0000000000000264

Up to 30% of patients report at least one antibiotic allergy, but oftentimes these antibiotic allergies are misdiagnosed. In fact, of the 10% of patients reporting penicillin allergies, 90%–98% are not truly allergic. In an era of increasing antibiotic resistance coupled with a limited number of new antibiotics, evaluating antibiotic allergies is critical in providing optimal patient care. Differentiating adverse drug reactions from antibiotic allergies may seem like a daunting task for clinicians and providers, especially in the emergency department, where decisions are made quickly. However, a systemic approach, including medical record review coupled with patient and/or family interview, is vital in managing patients with antibiotic allergies. Inappropriate, alternative antibiotics are frequently chosen due to patient allergies, and data suggest higher rates of broad-spectrum antibiotic use, antibiotic resistance, and poor outcomes as a result. Herein, we review antibiotic selection in patients reporting antibiotic allergies in the emergency department.

College of Pharmacy, University of Georgia, Albany (Dr Chastain); and Phoebe Putney Memorial Hospital, Albany, Georgia (Drs Chastain and Sams and Mr Steele).

Corresponding Author: Daniel B. Chastain, PharmD, BCIDP, AAHIVP, College of Pharmacy, University of Georgia, 1000 Jefferson St, Albany, GA 31701 (

Disclosure: The authors report no conflicts of interest.

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