127 Cues to improve antibiotic-allergy registration: A mixed-method stu 5 Validity and limitations A strength of our quality analysis was the use of routinely registered medical data from primary care. This data reflects daily practice regarding the registration of antibiotic allergies. A strength of our interviews was the inclusion of healthcare workers from all domains that register antibiotic allergies, hence providing a complete overview. A comprehensive approach is important as antibiotic allergy registrations clearly transcend the individual domains. The relevance is illustrated by the determinants that were identified regarding the interactions between healthcare domains and individual healthcare professionals. An advantage of semi-structured interviews is that it allows an interviewer the freedom to pursue more in-depth answers to specific questions, without compromising the comparison of interviews. One limitation of our semi-structured interviews was possible interviewer bias. Conscious or unconscious, an interviewer input may have influenced respondent answers. Participation bias may have also impacted our results, as participants with an affinity for or interest in antibiotic allergies may be more likely to participate in a study of this type. However, participating interviewees were diverse in terms of gender and experience and accurately represented healthcare providers. Conclusion Incorrect antibiotic allergy registration is a multifactorial and cross-domain problem. The causes are poor registration of symptoms and their duration, insufficient knowledge, lack of awareness and suboptimal communication between healthcare domains and ICT systems. Improving allergy registrations should be an antimicrobial stewardship priority and interventions should have a domain-transcending approach.
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