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. 2004 Summer;8(3):20-4.
doi: 10.7812/TPP/04.934.

Routine Penicillin Skin Testing in Hospitalized Patients with a History of Penicillin Allergy

Eric Macy, Linda B Roppe, Michael Schatz

Routine Penicillin Skin Testing in Hospitalized Patients with a History of Penicillin Allergy

Eric Macy et al. Perm J. 2004 Summer.

Abstract

Background: In selected inpatient settings, penicillin skin testing has been shown to affect antibiotic use. Routine penicillin skin testing has not been studied in hospitalized patients with a history of penicillin allergy.

Objectives: To determine whether routine penicillin skin testing at a large regional hospital affected antibiotic use and/or antibiotic side effects in hospitalized persons with a history of penicillin allergy.

Methods: A convenience sample of patients was penicillin skin tested from among those who had a history of penicillin allergy during any hospitalization from September 2002 through February 2003. Discharge coding was used to identify two age- and sex-matched control patients who had a history of penicillin allergy but who did not receive skin testing while hospitalized. All inpatient and outpatient antibiotic use, positive results of bacteriology culture obtained at any time from August 2002 through March 2003, and coded adverse reactions to medications were identified.

Results: Of the 13,172 patients admitted to the hospital during the study period, 1627 (12.35%) had a history of penicillin allergy; of these 1627 patients, 141 (8.7%) received skin testing. Use of antibiotic agents was common: 79.4% of all study subjects received at least one antibiotic agent. Penicillins were used in substantially more cases than controls. Cephalosporins were the most widely used class of antibiotic agents, accounting for 26.8% of all antibiotic courses used. Of the six antibiotic-associated adverse drug reactions in five (1.2%) of the study subjects, one adverse reaction was associated with a penicillin, and one was associated with a cephalosporin.

Conclusions: Routine penicillin skin testing in hospitalized patients is safe and allows more appropriate antibiotic use. To ensure that accurate information is available to support clinical care, hospitals should maintain a single centralized system for collecting data on drug allergy and testing.

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Figures

Figure 1.
Figure 1.
Flowchart illustrates study design for determining whether routine penicillin skin testing in hospitalized patients with history of penicillin allergy affected their use of antibiotic drugs, side effects of these drugs, or both
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References

    1. Macy E. Elective penicillin skin testing and amoxicillin challenge: effect on outpatient antibiotic use, cost, and clinical outcomes. J Allergy Clin Immunol. 1998 Aug;102(2):281–5. - PubMed
    1. Macy E, Richter PK, Falkoff R, Zeiger R. Skin testing with penicilloate and penilloate prepared by an improved method: amoxicillin oral challenge in patients with negative skin test responses to penicillin reagents. J Allergy Clin Immunol. 1997 Nov;100(5):586–91. - PubMed
    1. Li JT, Markus PJ, Osmon DR, Estes L, Gosselin VA, Hanssen AD. Reduction of vancomycin use in orthopedic patients with a history of antibiotic allergy. Mayo Clin Proc. 2000 Sep;75(9):902–6. - PubMed
    1. Arroliga ME, Wagner W, Bobek MB, Hoffman-Hogg L, Gordon SM, Arroliga AC. A pilot study of penicillin skin testing in patients with a history of penicillin allergy admitted to a medical ICU. Chest. 2000 Oct;118(4):1106–8. - PubMed
    1. Sade K, Holtzer I, Levo Y, Kivity S. The economic burden of antibiotic treatment of penicillin-allergic patients in internal medicine wards of a general tertiary care hospital. Clin Exp Allergy. 2003 Apr;33(4):501–6. - PubMed

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