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. 2023 Sep-Oct;45(5):255-260.
doi: 10.1097/JHQ.0000000000000395. Epub 2023 Jun 29.

Should Penicillin Allergy Testing Be Included as Part of Preoperative Testing?

Svjetlana Lozo, Daniel Wagner, Nirav Shah, Roger Goldberg, Adam Gafni-Kane, Anthony Solomonides

Should Penicillin Allergy Testing Be Included as Part of Preoperative Testing?

Svjetlana Lozo et al. J Healthc Qual. 2023 Sep-Oct.

Abstract

Introduction: Penicillin allergy is the most commonly reported drug allergy in the United States. Patients labeled with penicillin allergy are at risk of receiving broad-spectrum antibiotics for surgical site infection prophylaxis, which can lead to increased antibiotic resistance, higher morbidity, suboptimal antibiotic therapy, and higher medical costs. This study aimed to determine the true prevalence of penicillin allergy among surgical patients and to decrease the unnecessary use of broad-spectrum antibiotics.

Methods: A retrospective chart review was performed of patients who underwent urogynecologic surgery in 2017. In 2018, a quality initiative was started, and all patients reporting penicillin allergies were offered antibiotic allergy testing as part of their preoperative testing.

Results: In 2017, 15% of patients reported penicillin allergy and 52% of them received surgical prophylaxis with broad-spectrum antibiotics. In 2018, 463 patients underwent surgery, 55 of whom reported penicillin allergy and were offered penicillin allergy testing. 35 (64%) agreed to proceed with testing, and of those tested, 33 (94%) tested negative for penicillin allergy.

Conclusions: 94% of patients with stated penicillin allergy who consented to allergy testing proved to have negative test. Penicillin allergy testing should be considered as part of preoperative management.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Chen JR, Tarver SA, Alvarez KS, Tran T, Khan DA. A proactive approach to penicillin allergy testing in hospitalized patients. J Allergy Clin Immunol Pract. 2017;5(3):686-693.
    1. Vorobeichik L, Weber EA, Tarshis J. Misconceptions surrounding penicillin allergy: Implications for anesthesiologists. Anesth Analg. 2018;127(3):642-649.
    1. Salkind AR, Cuddy PG, Foxworth JW. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy. J Am Med Assoc. 2001;285(19):2498-2505.
    1. Joint Task Force on Practice Parameters. American Academy of Allergy, Asthma and Immunology. American College of Allergy, Asthma and Immunology. Joint Council of Allergy, Asthma and Immunology. Drug allergy: An updated practice parameter. Ann Allergy Asthma Immunol. 2010;105(4):259-273.
    1. Blumenthal KG, Ryan EE, Li Y, Lee H, Kuhlen JL, Shenoy ES. The impact of a reported penicillin allergy on surgical site infection risk. Clin Infect Dis. 2018;66(3):329-336.

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