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Expanding Penicillin Allergy Evaluation in Hospitalized Patients

  • Martha T. DesBiens
    Correspondence
    Requests for reprints should be addressed to Martha T. DesBiens, MD, MPH
    Affiliations
    Department of Medicine, Section of Infectious Disease, Nuvance Health, Southbury, Conn

    The Robert Larner M.D. College of Medicine at The University of Vermont, Burlington

    Department of Medicine, Section of Infectious Disease & International Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH

    Geisel School of Medicine at Dartmouth, Hanover, NH
    Search for articles by this author
  • Michael S. Calderwood
    Affiliations
    Department of Medicine, Section of Infectious Disease & International Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH

    Geisel School of Medicine at Dartmouth, Hanover, NH
    Search for articles by this author
  • Erin L. Reigh
    Affiliations
    Geisel School of Medicine at Dartmouth, Hanover, NH

    Department of Medicine, Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
    Search for articles by this author
      Around 15% of hospitalized patients report a penicillin allergy, yet <3% of individuals are found to have a significant immune-mediated allergy on testing.
      Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma and ImmunologyAmerican College of Allergy, Asthma and ImmunologyJoint Council of Allergy, Asthma and Immunology
      Drug allergy: an updated practice parameter.
      • Trubiano JA
      • Adkinson NF
      • Phillips EJ
      Penicillin allergy is not necessarily forever.
      • Shenoy ES
      • Macy E
      • Rowe T
      • Blumenthal KG
      Evaluation and management of penicillin allergy: a review.
      Furthermore, at least 80% of individuals with immunoglobulin E (IgE)-mediated allergy to penicillin lose their allergy after 10 years of avoidance of the drug.
      Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma and ImmunologyAmerican College of Allergy, Asthma and ImmunologyJoint Council of Allergy, Asthma and Immunology
      Drug allergy: an updated practice parameter.
      • Trubiano JA
      • Adkinson NF
      • Phillips EJ
      Penicillin allergy is not necessarily forever.
      • Shenoy ES
      • Macy E
      • Rowe T
      • Blumenthal KG
      Evaluation and management of penicillin allergy: a review.
      Despite low likelihood of significant risk, most adults labeled with penicillin allergy go on to lifelong avoidance of the drug class, driving unnecessary use of alternative antibiotics that may be less effective, have greater associated adverse events, and cost more to the medical system.
      • Jeffres MN
      • Narayanan PP
      • Shuster JE
      • Schramm GE
      Consequences of avoiding β-lactams in patients with β-lactam allergies.
      • Macy E
      • Contreras R
      Health care use and serious infection prevalence associated with penicillin "allergy" in hospitalized patients: A cohort study.
      • Lee CE
      • Zembower TR
      • Fotis MA
      • et al.
      The incidence of antimicrobial allergies in hospitalized patients: implications regarding prescribing patterns and emerging bacterial resistance.
      • Mattingly TJ
      • Fulton A
      • Lumish RA
      • et al.
      The cost of self-reported penicillin allergy: a systematic review.

      Keywords

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      References

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