Kimberly Blumenthal
speaker
187 appearances
2 recordings
1 series
first heard Jan 2025
last heard 17 Jul
Kimberly Blumenthal’s voice in public audio — every appearance, attributed to the second.
Trend
recordings per month · last 12 monthsRecordings per month over the last 12 months — 1 in all, peaking in Jul 2026 with 1.
Appearances
We did an all-cause mortality study in a very nicely controlled observational study. 14% increased all-cause mortality. Wait a minute.
There's avoiding antibiotic resistance, C. diff colitis, avoiding too long of hospital stays, avoiding surgical infections if you had needed an operation. And then there's avoiding other adverse events that result from a choice of antibiotic that is just more toxic and by its nature caused more renal failure or caused more diarrhea or whatnot.
It's such a no-brainer. I mean, when you give me this description, what comes to mind is two people who have strep throat. Strep throat and a penicillinology label. One person gets penicillin. That's indicated for penicillin. Strep throat goes away. No long-term sequelae. They're fine. It was cheap. And then the other person gets a Z-Pak, azithromycin. And it doesn't fully go away.
Then they call back and they get another antibiotic. Maybe this time they get a bigger antibiotic. And that causes some problem. They might get a tonsillar abscess. They get a quinolone, ciprofloxacin unnecessarily, or some other medication.
We can evaluate for penicillin allergy with simple tests. And these simple tests need to be delivered to that 10 percent of America and reimbursed appropriately and taught to a non-specialist workforce. Could be a welcome to college visit, a welcome to Medicare visit,
Just my health care system would be millions. If we evaluated penicillin allergy, delabeled the appropriate ones, we would save millions of dollars, just my health care system. So it must be in the billions.
You save on antibiotic expenditure.
Yes. You'd save on adverse effect avoidance.
Yes, and some of these adverse effects lead you to the emergency room and another hospitalization. You'd save on surgical infections, a tremendously costly thing.
In our hospitals, without an allergist involved, there is sort of algorithmic care that can clear allergy in low-risk situations with just a protocol, just a little bit more observation. You're ready in the hospital. You're being observed.
We do it when patients have infections. So we don't do it electively, like if you're there for something not related. But if you have an infection that an allergy is getting in the way of best care, we have a two-step drug challenge process. And as long as the patient's healthy enough to do that, we do it. So we give a small amount, watch the patient, give a full amount, watch the patient.
And then if that's the drug that they need to be treated with, they just continue that drug right then and there.
You would kill some people by accident. And in America, it's just a non-starter.
Well, there's also this doctor, first do no harm, like the oath we take, and it feels wrong to just disregard allergy labels entirely.
I can tell you with confidence that I was the first penicillin allergy grant that the NIH funded in 30 years. Whose area is it? Is it infectious disease? Is it allergy? It's multidisciplinary. Is it surgery? Is it obstetrics? Because penicillins are used by everybody. Dentists. It was very hard to know who takes ownership of something that crosses every single discipline.
We were trying so hard. I was working with Thermo Fisher Scientific. They have developed a blood test panel, and they wanted to see if it worked in allergic individuals from America. We identified in the Boston area everyone that reacted to penicillin in front of our faces in the last few years. We sent them the blood of these individuals, and I think it picked up like three.
It was like three of 20. It didn't pick it up yet.
The conclusion was, well, they were allergic in the last 5, 10 years. Maybe they weren't allergic now. So I have to bring them back, retest them. And then these patients, they're like needles in haystacks, right? We combed the records of all Mass General Brigham to find these 22 penicillin allergics. We really need to say, OK, you reacted to penicillin in front of my face today.
Grab your blood and then send it to be able to know that they were true positives.
Slowly.
Showing 161–180 of 187 · page 9 of 10
← Previous
Next →