# Implementation of a hospital-wide EHR-integrated antibiotic challenge order set

## TL;DR

A new system was created to safely test antibiotic allergies in hospitals using electronic health records.

## Contribution

A hospital-wide EHR-integrated order set was implemented to standardize antibiotic challenges for patients with allergies.

## Key findings

- 104 patients were challenged in the first year using the new system.
- The system included embedded guidance for antibiotic selection, dosage, and monitoring.
- The order set was adopted by hospitalists and subspecialists.

## Abstract

We implemented an electronic health record-integrated order set to standardize direct antibiotic challenges for patients with reported antibiotic allergies across nine healthcare facilities. In the first year, 104 patients were challenged (79% oral; 39% two-step). Embedded antibiotic selection, dosage, monitoring parameters, reaction guidance, and rescue medications facilitated uptake by hospitalists and subspecialists.