Penicillin Allergy Testing: An Outpatient Nurse-Driven Program for Patients With Cancer.

Background Penicillin allergy testing (PAT) can decrease the use of unnecessary antibiotics by clarifying who is truly allergic. Objectives This article describes the development and implementation of an oncology outpatient nurse-driven PAT program. Methods A nurse-driven program, initiated with allergy screening at the first encounter, was designed to identify patients with oncologic diagnoses eligible for PAT. Once verified eligible, patients undergo a three-step testing process (scratch test, intradermal injection, and IV challenge dose) administered by the infusion nurse. Findings From November 2018 to December 2019, 82 outpatients with reported penicillin allergies were screened; 90% were eligible for PAT, and 97% of patients tested were negative for penicillin allergy. A significant reduction in aztreonam use among patients admitted for hematopoietic stem cell transplantation was also noted as compared to before PAT was offered.