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

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.