Assessment of penicillin allergy evaluation practices among clinicians in China: a nationwide cross-sectional survey.

OBJECTIVE: This study investigated the perceived clinicians' roles in penicillin allergy assessment among medical staff in tertiary hospitals in China. DESIGN: This was a multicentre cross-sectional survey. SETTING: The study was conducted at 89 tertiary hospitals in eastern and western China from March to May 2024. PARTICIPANTS: A survey was conducted involving 8493 medical staff from tertiary hospitals in eastern and western China using multistage sampling. OUTCOME MEASURES: A self-designed questionnaire was used to assess evaluation status of penicillin allergy assessment, including allergy history assessment and recording, skin test result evaluation during hospitalisation, allergic reaction recording at discharge and awareness of allergy assessment teams. RESULTS: Among 8493 healthcare professionals (doctors 40.0%, nurses 56.3%, pharmacists 3.7%), significant gaps existed in penicillin allergy documentation: while 92.0% acknowledged the need to document specific drug names, only 66.2% practised this (nurses 62.2% vs pharmacists 82.0%, p<0.01). Nurses dominated skin test evaluation (95.3% participation), with 77.5% of all staff endorsing their primary role. For ambiguous test results, 54.6% preferred multi-person consensus (nurses 63.9%, p<0.01). Post-discharge documentation prioritised drug names (94.4%) over clinical indications (70.3%). Pharmacists demonstrated superior documentation awareness (p<0.05). Only 45.5% confirmed having an antimicrobial allergy assessment team, though clinical pharmacists (89.2%) and specialist nurses (88.2%) were deemed essential members. CONCLUSIONS: Currently, the assessment and recording methods for antimicrobial allergies by the medical staff of tertiary hospitals in China are not sufficiently accurate. Nurses play a key role in the assessment of antimicrobial allergies. Thus, medical staff, especially nurses, should receive more vigorous training, and structured assessment tools for antimicrobial allergies based on clinical decision support systems should be devised for them. Our findings also reiterate the need to establish penicillin allergy assessment teams at the hospital level.