PMID- 33132684
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220418
IS  - 1078-4497 (Print)
IS  - 1945-337X (Electronic)
IS  - 1078-4497 (Linking)
VI  - 37
IP  - 10
DP  - 2020 Oct
TI  - Penicillin Allergy Delabeling Can Decrease Antibiotic Resistance, Reduce Costs, 
      and Optimize Patient Outcomes.
PG  - 460-465
LID - 10.12788/fp.0040 [doi]
AB  - BACKGROUND: Antibiotics are one of the most frequently prescribed medications. 
      Among all classes of antibiotics, penicillins are prescribed due to their 
      clinical efficacy, cost-effectiveness, and general safety. Unfortunately, 
      penicillins also are the most common drug allergy listed in patient medical 
      records. Increasing evidence shows that > 90% of patients labeled with a 
      penicillin allergy are not allergic to penicillins and associated beta-lactams. The 
      health care consequences of penicillin allergy in the setting of military 
      medicine and readiness are important to consider. OBSERVATIONS: In the US, 8 to 
      10% of the population and up to 15% of hospitalized patients have a documented 
      penicillin allergy, limiting the use of these effective antibiotics. When 
      treating a patient with a penicillin allergy, many clinicians avoid prescribing 
      all beta-lactam antibiotics and stay away from cephalosporins due to the concern for 
      potential cross-reactivity. The cost of treating those with a documented 
      penicillin allergy is greater than the cost for those who can receive penicillin, 
      as treatment with broad-spectrum antibiotics often results in longer 
      hospitalizations with increased rates of adverse effects (AEs). Despite 
      preventive programs such as vaccinations, hygiene measures, and prophylactic 
      antibiotics, military personnel are at increased risk for infections due to the 
      military's mobile nature and crowded living situations. CONCLUSIONS: Many 
      patients report an allergy to penicillin, but only a small portion have a true 
      immune-mediated allergy. Given the clinical, public health, and economic costs 
      associated with a penicillin allergy label, evaluation and clearance of 
      penicillin allergies improves clinical outcomes, decreases AEs from higher risk 
      alternative broad-spectrum antibiotics, and prevents the spread of antibiotic 
      resistance. In military personnel, penicillin delabeling improves readiness with 
      optimal antibiotic options and avoidance of unnecessary risks, expediting return 
      to full duty.
CI  - Copyright (c) 2020 Frontline Medical Communications Inc., Parsippany, NJ, USA.
FAU - Lee, Rachel U
AU  - Lee RU
AD  - is a Staff Allergist and Immunologist in the Division of Allergy, Department of 
      Internal Medicine at the Naval Medical Center in San Diego, California.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Fed Pract
JT  - Federal practitioner : for the health care professionals of the VA, DoD, and PHS
JID - 9500574
PMC - PMC7592897
COIS- Author disclosures The author reports no actual or potential conflicts of 
      interest with regard to this article.
EDAT- 2020/11/03 06:00
MHDA- 2020/11/03 06:01
PMCR- 2020/10/01
CRDT- 2020/11/02 06:13
PHST- 2020/11/02 06:13 [entrez]
PHST- 2020/11/03 06:00 [pubmed]
PHST- 2020/11/03 06:01 [medline]
PHST- 2020/10/01 00:00 [pmc-release]
AID - fp-37-10-460 [pii]
AID - 10.12788/fp.0040 [doi]
PST - ppublish
SO  - Fed Pract. 2020 Oct;37(10):460-465. doi: 10.12788/fp.0040.