Methods : A 10-item online survey was distributed by the EIN in September 2015 to 1172 members practicing adult ID, 323 pediatric and 24 both. Two reminders were sent to non-respondents.
Results : Of 736/1,545 (48%), only 43% had skin prick/intradermal testing (SPT) available and 30% were either unaware of options or had none available. Although 78% overall suggested that a negative test would lead to AAL removal, those with > 15 years experience were significantly less likely to remove AAL (P<0.001). Most felt AAL removal would aid antibiotic selection (95%), appropriateness (92%), safety (74%) and antimicrobial-stewardship (AMS) (82%). Although 68% overall advocated incorporation of AAT into AMS, those with < 15 years experience were significantly more likely to support this (p=0.006). In settings of a remote reaction history, point-of-care testing (40%) was preferred to antibiotic desensitization (7%).
Conclusions: ID physicians perceive inadequate access to AAT services. Less experienced physicians were both more likely to view AAT as a means to remove AAL and advocate its incorporation into AMS. A generational shift appears to be occurring that should support AAT as a tool to improve antibiotic appropriateness.