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Updated: Mar 3, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

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US antibiotic stewardship and penicillin allergy

Kara J Wada1, Karen H Calhoun

  • 1Division of Allergy, Department of Otolaryngology Head & Neck Surgery, The Ohio State University Wexner School of Medicine, Columbus, Ohio, USA.

Current Opinion in Otolaryngology & Head and Neck Surgery
|April 21, 2017
PubMed

Insights

Many patients with a penicillin allergy on record do not have a true allergy. Allergy history, skin testing, and graded dosing can safely confirm true penicillin allergy, enabling the use of narrower-spectrum antibiotics.

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.
Abstract

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