US antibiotic stewardship and penicillin allergy

Area of Science:

• Otolaryngology
• Allergy and Immunology
• Infectious Diseases

Background:

• Up to 15% of hospitalized patients have a recorded penicillin allergy.
• Less than 10% of those with a recorded allergy have a true allergy.

Purpose of the Study:

• To improve antibiotic stewardship among otolaryngologists.
• To detail current approaches for evaluating penicillin allergy.

Main Methods:

• Review of current literature on penicillin allergy assessment.
• Detailed allergy history taking.
• Skin testing and graded-dose administration for penicillin-allergic patients.

Main Results:

• A significant number of patients with a recorded penicillin allergy are misdiagnosed.
• Accurate assessment can reclassify patients as non-allergic to penicillin.

Conclusions:

• Comprehensive allergy evaluation can safely identify patients who can receive penicillin.
• This approach supports the use of narrower-spectrum antibiotics.
• Appropriate penicillin use can lead to cost savings.