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Should Penicillin Allergy Skin Testing be a Thing of the PAST?

Should Penicillin Allergy Skin Testing be a Thing of the PAST?

June 5, 2020

Many, many, many patients report they have penicillin (PCN) allergy. But while nearly 10% report being allergic to PCN, fewer than 1% have a true allergy. And this hampers antimicrobial stewardship efforts because clinicians are often forced to turn to agents with a broader spectrum, that are more expensive, and more likely to cause adverse effects including the development of resistance. However, determining whether a patient has a true PCN allergy is time-consuming and expensive. Historically, patients were sent to an allergist for PCN allergy skin testing (PAST) followed by oral provocation challenge (OPC). What if patients could skip past the skin test and receive a direct OPC instead? Direct OPC may not only increase patient willingness to be tested but also the feasibility of offering testing in primary care (and perhaps community pharmacy) settings.

Guest Authors:  Frank A Fanizza, PharmD, BCACP and Emily S Prohaska, PharmD, BCACP, BCGCP

Music by Good Talk

Cutting Down HIV Treatment to a 2-Drug Regimen

Cutting Down HIV Treatment to a 2-Drug Regimen

May 24, 2018

While multi-drug combination therapies for HIV has resulted in longer lifespans, simplified medication regimens are needed to reduce pill-burden in an aging population with HIV. Two-drug regimens are potentially attractive because they may minimize drug exposure; reduce risks for adverse effects, drug-drug interactions, and long-term toxicities; and potentially increase patient adherence.  The SWORD-1 and SWORD-2 trials evaluated the efficacy and safety of a two-drug regimen to maintain viral suppression in HIV infected patients.

Guest Authors Tinh An (April) Nguyen, PharmD and Jihae Lim, PharmD

Music by Good Talk

Don’t Kid Yourself: Broad- versus Narrow-Spectrum Antibiotics in Children

Don’t Kid Yourself: Broad- versus Narrow-Spectrum Antibiotics in Children

April 27, 2018

Overuse of broad-spectrum antibiotics can lead to antimicrobial resistance, increased cost, and higher prevalence of adverse drug reactions. Nearly 2 million infections and 23,000 deaths are caused by bacteria that are antibiotic-resistant each year in the United States costing the healthcare system an estimated 20 billion dollars. Moreover, adverse reactions to antibiotics are the most common reason for pediatric patients to visit the emergency department.  Narrow-spectrum antimicrobials are generally preferred, but there are instances where broader coverage is recommended.  A recent study attempts to “clean up” the debate by examining the benefits and risks of using narrow- versus broad-spectrum antibiotics in children with acute respiratory tract infections.

Guest Authors:  Amber Giles, PharmD, MPH, BCPS, AAHIVP  and Paige Hughes, PharmD

Music by Good Talk

Vitamin D to Prevent Respiratory Tract Infections: Is the Evidence Dazzling or Disappointing?

Vitamin D to Prevent Respiratory Tract Infections: Is the Evidence Dazzling or Disappointing?

June 26, 2017

Observational studies and systematic reviews have shown an association between low vitamin D concentrations and acute respiratory tract infections (ARTIs). An association is one thing, but can vitamin D supplementation reduce the risk of ARTIs?  That’s what a recent systematic review and meta-analysis attempted to determine.

Guest Author:  Amanda Schartel, Pharm.D., BCACP

Theme music by Good Talk

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