1131. Prevalence and Characteristics of Non-β-Lactam Allergy Labeling at a Children’s Hospital

Abstract Background Limited data are available on non-β-lactam (NBL) antibiotic allergy labeling in children. Understanding the incidence and patterns of NBL labeling is important as NBL hypersensitivity testing lacks standardization and false labeling may constrain therapeutic options and compromise antimicrobial stewardship. Methods We conducted a retrospective review of patients at our tertiary care pediatric facility and associated clinics who had first reported allergy to NBL antibiotics from January 1, 2015 to December 31, 2015. Demographic data, NBL subclass, severity, description of reaction, and ICD-9/10 diagnostic codes were recorded. In addition, subsequent antibiotic during the following 3 years (2016–2018) was determined. NBL allergy descriptions, when reported, were categorized based on severity and type of reaction. Results Of 35,796 patients with first clinical encounters in 2015, 223 patients (0.6%) had at least one NBL allergy reported, 1370 (3.8%) had a β-lactam allergy reported, and 101 (0.3%) patients had both an NBL and β-lactam allergy. There were 16 patients with two NBL allergies. The median age of patients with NBL allergy was 9.0 years. NBL classes and allergic reaction types are listed in the tables. Chronic conditions of patients with NBL allergy included gastrointestinal disease (n = 51), neurological disease (n = 37), malignancy (n = 36), bone marrow or solid-organ transplant (n = 4), and cystic fibrosis (n = 5). In the subsequent 3 years, 28 patients with NBL allergies received 129 systemic courses of antibiotics as inpatients, including 8 patients who received ≥10 courses. Conclusion Although not as common as β-lactam allergies, NBL allergies were noted in a substantial number of new patients. When described, the majority of patients did not have severe reactions, and were most likely nonallergic adverse reactions. As many of the patients have chronic conditions and require subsequent antibiotics, adjudication of true allergy status may be beneficial. Disclosures All authors: No reported disclosures.