P4. Antimicrobial stewardship (inpatient/outpatient pediatric focused)
Oral Abstract Submission
Most beta-lactam antibiotic allergies (BLA) are incorrectly diagnosed and could be de-labeled. Adult patients with BLA are more likely to receive broader-spectrum antimicrobials and experience worse health outcomes than non-allergic patients. Similar studies on the impact of BLA on antimicrobial use and clinical outcomes are limited in pediatrics. Our objective was to compare antimicrobial use, and clinical and economic outcomes between hospitalized children with and without BLA.
39,785 patients were identified including 2897 (7%) with BLA. The prevalence of BLA increased with age (Fig 1). 2459 (85%) patients with BLA were matched to a control. Patients with BLA had higher odds of receiving broader-spectrum antibiotics (OR 2.35, 95% CI: 2.07-2.67) and had greater antimicrobial costs (1.21 fold increase, 95% CI: 1.08-1.35) than non-allergic patients (Fig 2). There were no differences in LOS, total antimicrobial days, or 30-day readmission (Fig 2).
Pediatric patients with BLA are more likely to receive broader-spectrum antibiotics and incur higher antimicrobial costs than matched controls. De-labeling interventions could reduce unnecessary exposure to these agents and lower costs.