Dataset Information

Penicillin de-labelling in vancouver, British Columbia, Canada: comparison of approaches, outcomes and future directions.

ABSTRACT:

Background

Inaccurate penicillin allergy labels lead to inappropriate antibiotic prescriptions and harmful patient consequences. System-wide efforts are needed to remove incorrect penicillin allergy labels, but more health services research is required on how to best deliver these services.

Methods

Data was extracted from five hospitals in Vancouver, British Columbia, Canada from October 2018-May 2022. The primary outcomes of this study were to outline de-labelling protocol designs, identify the roles of various healthcare professionals in de-labelling protocols and identify rates of de-labelling penicillin allergies and associated adverse events at various institutions. Our secondary outcome was to describe de-labelling rates for special populations, including pediatric, obstetric and immunocompromised subpopulations. To achieve these outcomes, participating institutions provided their de-labelling protocol designs and data on program participants. Protocols were then compared to find common themes and differences. Furthermore, adverse events were reviewed and percentages of patients de-labelled at each institution and in total were calculated.

Results

Protocols demonstrated a high level of variability, including different methods of participant identification, risk-stratification and roles of providers. All protocols used oral and direct oral challenges, heavily involved pharmacists and had physician oversight. Despite the differences, of the 711 patients enrolled in all programs, 697 (98.0%) were de-labelled. There were 9 adverse events (1.3%) with oral challenges with mainly minor symptoms.

Conclusions

Our data demonstrates that de-labelling programs effectively and safely remove penicillin allergy labels, including pediatric, obstetric and immunocompromised patients. Consistent with current literature, most patients with a penicillin allergy label are not allergic. De-labelling programs could benefit from increasing clinician engagement by increasing accessibility of resources to providers, including guidance for de-labelling of special populations.

SUBMITTER: Saravanabavan S

PROVIDER: S-EPMC10114447 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Penicillin de-labelling in vancouver, British Columbia, Canada: comparison of approaches, outcomes and future directions.

Saravanabavan Sujen S Aulakh Amneet A Douglas Josh J Elwood Chelsea C Erdle Stephanie S Grant Jennifer J Kang Kristopher T KT Kwan Natasha N Lacaria Katie K Lau Tim T Y TTY Lee Colin C Leung Victor V Lin Yu-Chen YC Mah Allison A Nguyen Anne A Paquette Vanessa V Roberts Ashley A Watt Melissa M Van Schalkwyk Julie J Zhang Bei Yuan BY Mak Raymond R Wong Tiffany T

Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology 20230418 1

<h4>Background</h4>Inaccurate penicillin allergy labels lead to inappropriate antibiotic prescriptions and harmful patient consequences. System-wide efforts are needed to remove incorrect penicillin allergy labels, but more health services research is required on how to best deliver these services.<h4>Methods</h4>Data was extracted from five hospitals in Vancouver, British Columbia, Canada from October 2018-May 2022. The primary outcomes of this study were to outline de-labelling protocol design ...[more]

PMID: 37072861

Similar Datasets

Project description:ObjectivesFew studies reported COVID-19 cases in schools during the 2020/21 academic year in a setting of uninterrupted in-person schooling. The main objective was to determine the SARS-CoV-2 seroprevalence among school staff in Vancouver public schools.DesignCumulative incident COVID-19 cases among all students and school staff based on public health data, with an embedded cross-sectional serosurvey among a school staff sample that was compared to period, age, sex and geographical location-weighted data from blood donors.SettingVancouver School District (British Columbia, Canada) from kindergarten to grade 12.ParticipantsActive school staff enrolled from 3 February to 23 April 2021 with serology testing from 10 February to 15 May 2021.Main outcome measuresSARS-CoV-2 seroprevalence among school staff, based on spike (S)-based (unvaccinated staff) or N-based serology testing (vaccinated staff).ResultsPublic health data showed the cumulative incidence of COVID-19 among students attending in-person was 9.8 per 1000 students (n=47 280), and 13 per 1000 among school staff (n=7071). In a representative sample of 1689 school staff, 78.2% had classroom responsibilities, and spent a median of 17.6 hours in class per week (IQR: 5.0-25 hours). Although 21.5% (363/1686) of surveyed staff self-reported close contact with a COVID-19 case outside of their household (16.5% contacts were school-based), 5 cases likely acquired the infection at school based on viral testing. Sensitivity/Specificity-adjusted seroprevalence in 1556/1689 staff (92.1%) was 2.3% (95% CI: 1.6% to 3.2%), comparable to a sex, age, date and residency area-weighted seroprevalence of 2.6% (95% CI: 2.2% to 3.1%) among 5417 blood donors.ConclusionSeroprevalence among staff was comparable to a reference group of blood donors from the same community. These data show that in-person schooling could be safely maintained during the 2020/21 school year with mitigation measures, in a large school district in Vancouver, Canada.

Project description:BACKGROUND:Climate change is increasing the number and intensity of extreme weather events in many parts of the world. Precipitation extremes have been linked to both outbreaks and sporadic cases of waterborne illness. We have previously shown a link between heavy rain and turbidity to population-level risk of sporadic cryptosporidiosis and giardiasis in a major Canadian urban population. The risk increased with 30 or more dry days in the 60 days preceding the week of extreme rain. The goal of this study was to investigate the change in cryptosporidiosis and giardiasis risk due to climate change, primarily change in extreme precipitation. METHODS:Cases of cryptosporidiosis and giardiasis were extracted from a reportable disease system (1997-2009). We used distributed lag non-linear Poisson regression models and projections of the exposure-outcome relationship to estimate future illness (2020-2099). The climate projections are derived from twelve statistically downscaled regional climate models. Relative Concentration Pathway 8.5 was used to project precipitation derived from daily gridded weather observation data (~ 6 × 10 km resolution) covering the central of three adjacent watersheds serving metropolitan Vancouver for the 2020s, 2040s, 2060s and 2080s. RESULTS:Precipitation is predicted to steadily increase in these watersheds during the wet season (Oct. -Mar.) and decrease in other parts of the year up through the 2080s. More weeks with extreme rain (>90th percentile) are expected. These weeks are predicted to increase the annual rates of cryptosporidiosis and giardiasis by approximately 16% by the 2080s corresponding to an increase of 55-136 additional cases per year depending upon the climate model used. The predicted increase in the number of waterborne illness cases are during the wet months. The range in future projections compared to historical monthly case counts typically differed by 10-20% across climate models but the direction of change was consistent for all models. DISCUSSION:If new water filtration measures had not been implemented in our study area in 2010-2015, the risk of cryptosporidiosis and giardiasis would have been expected to increase with climate change, particularly precipitation changes. In addition to the predicted increase in the frequency and intensity of extreme precipitation events, the frequency and length of wet and dry spells could also affect the risk of waterborne diseases as we observed in the historical period. These findings add to the growing evidence regarding the need to prepare water systems to manage and become resilient to climate change-related health risks.

Project description:BackgroundThe purpose of this study was to explore factors associated with COVID-19 vaccine intentions among school staff as high vaccine uptake is essential to ensure schools return to normal activities.MethodsStaff (e.g., teachers, administrators, student support workers) from three urban school districts in the Greater Vancouver Area of British Columbia, Canada completed a survey between February and June 2021 (n = 2,393) on COVID-19 vaccine intentions and perceptions (i.e., acceptance of routine vaccines, benefits and risks of vaccination, susceptibility to, and severity of COVID-19, recommendation by authority figures, information mistrust and conspiracy beliefs) as part of a COVID-19 seroprevalence study. Confirmatory factor analysis followed by multiple logistic regression models adjusting for relevant covariates were used to identify vaccine perceptions uniquely associated with (a) intention to get the COVID-19 vaccine (intention), and (b) intention to get vaccinated right away (urgency).ResultsIn total, 95.4% of participants of the seroprevalence study completed the vaccine questionnaire, corresponding to 17.7% of the target population. Vaccine intention was associated with staff who valued expert recommendations (AOR = 10.5, 95% CI = 7.39-14.90) accepted routine vaccines (AOR = 1.94, 95% CI = 1.26-2.98) and perceived higher benefits (AOR = 1.29, 95% CI = 1.01-1.65) and lower safety risks of vaccination (AOR = 0.40, 95% CI = 0.29-0.54). Comparable associations were found with vaccine urgency. Perceived susceptibility to the COVID-19 virus was uniquely associated with vaccine urgency (AOR = 1.30, 95% CI = 1.05-1.61). A significant interaction effect (p = 0.01) revealed that staff who expressed mistrust in COVID-19 information intended to get vaccinated only if they also perceived high benefits of vaccination.ConclusionsEducation about the risks and benefits of COVID-19 vaccines from a trusted source had the strongest relationship with vaccine intentions among this occupational group. Notably, those who expressed mistrust in information still intended to get vaccinated if they also perceived strong benefits of the vaccine.

Project description:BackgroundOnly one species of large carpenter bee, Xylocopa virginica (Linnaeus, 1771), has been recorded from Canada, albeit restricted to southern Ontario and Quebec. However, a single female specimen identified by Hurd in 1954 as X. varipuncta Patton, 1879 from British Columbia is in the C.A. Triplehorn Insect Collection at The Ohio State University (OSUC), suggesting that this species was accidentally introduced into coastal western Canada. As wood-nesters, many large carpenter bees are likely capable of expanding their range great distances by natural and unnatural transport methods while nesting inside suitable substrates, the presumed mode of transport into western Canada, and likely elsewhere. The ease at which the nests are transported has likely contributed to the nomenclatural and distributional ambiguity surrounding this species due to morphological similarities of specimens from North America, Hawaii, and several South Pacific islands.New informationBy comparing DNA barcodes of specimens from the western United States to specimens from Hawaii, we confirm the early opinion of P.H. Timberlake (Timberlake 1922) that specimens long established on the Hawaiian Islands are the same X. varipuncta from continental North America. Furthermore, these DNA barcode sequences also match those of specimens identified as X. sonorina Smith, 1874 from the French Polynesian and Samoan Islands, thus fully supporting the opinion of Groom et al. (2017) that all are likely conspecific. As X. sonorina, a species described from and likely introduced to Hawaii is the oldest name available, X. varipuncta is here placed into synonymy. Additional research will be needed to trace the timing and pathway of introduction and establishment of X. sonorina; it is presumed that the species is native to the southwestern United States but has been established in Hawaii since the mid-1800s. It is also established in French Polynesia, the Samoan Islands, and likely other south Pacific islands, with additional records of occurrence from Java, New Zealand, and now Canada.

Dataset Information

Penicillin de-labelling in vancouver, British Columbia, Canada: comparison of approaches, outcomes and future directions.

Background

Methods

Results

Conclusions

Publications

Penicillin de-labelling in vancouver, British Columbia, Canada: comparison of approaches, outcomes and future directions.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets