Journal article
Antibiotic use after removal of penicillin allergy label
Pediatrics, Vol.141(5)
2018
Abstract
BACKGROUND: Penicillin allergy is commonly reported in the pediatric emergency department. We previously performed 3-tier penicillin allergy testing on children with low-risk symptoms, and 100% tolerated a penicillin challenge without an allergic reaction. We hypothesized that no serious allergic reactions would occur after re-exposure to penicillin and that prescription practices would change after testing.
METHODS: We performed a follow-up case series of 100 children whose test results were negative for penicillin allergy. Research staff administered a brief follow-up phone survey to the parent and primary care provider of each patient tested. We combined the survey data and summarized baseline patient characteristics and questionnaire responses. We then completed a 3-tier economic analysis from the prescription information gathered from surveys in which cost savings, cost avoidance, and potential cost savings were calculated.
RESULTS: A total of 46 prescriptions in 36 patients were reported by the primary care provider and/or parents within the year after patients were tested for penicillin allergy. Twenty-six (58%) of the prescriptions filled were penicillin derivatives. One (4%) child developed a rash 24 hours after starting the medication; no child developed a serious adverse reaction after being given a penicillin challenge. We found that the cost savings of delabeling patients as penicillin allergic was $1368.13, the cost avoidance was $1812.00, and the total potential cost savings for the pediatric emergency department population was $192 223.00.
CONCLUSIONS: Children with low-risk penicillin allergy symptoms whose test results were negative for penicillin allergy tolerated a penicillin challenge without a severe allergic reaction developing. Delabeling children changed prescription behavior and led to actual health care savings.
Details
- Title
- Antibiotic use after removal of penicillin allergy label
- Authors/Creators
- D. Vyles (Author/Creator) - Section of Pediatric Emergency Medicine andA. Chiu (Author/Creator) - Medical College of WisconsinJ. Routes (Author/Creator) - Medical College of WisconsinM. Castells (Author/Creator) - Brigham and Women's HospitalE.J. Phillips (Author/Creator) - Vanderbilt UniversityJ. Kibicho (Author/Creator) - University of Wisconsin–MilwaukeeD.C. Brousseau (Author/Creator) - Section of Pediatric Emergency Medicine and
- Publication Details
- Pediatrics, Vol.141(5)
- Publisher
- American academy of Pediatrics
- Identifiers
- 991005543806507891
- Copyright
- © 2018 by the American Academy of Pediatrics
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.265 Dermatology - Skin Allergies
- 1.265.1140 Drug Hypersensitivity
- Web Of Science research areas
- Pediatrics
- ESI research areas
- Clinical Medicine