Cost and Risk Analysis of Lifelong Penicillin Allergy

Area of Science:

• Infectious Diseases
• Pharmacoeconomics
• Clinical Microbiology

Background:

• Penicillin allergy labels necessitate alternative antibiotic choices, potentially impacting treatment costs and outcomes.
• Understanding the long-term economic and clinical implications of penicillin allergy labels is crucial for healthcare management.

Purpose of the Study:

• To estimate and compare the lifetime antibiotic costs for patients labeled penicillin-allergic before age 10 versus those not labeled.
• To compare antibiotic utilization patterns and associated risks of adverse effects between these two patient groups.

Main Methods:

• Retrospective analysis of lifetime antibiotic costs and utilization.
• Comparison of antibiotic expenditure and drug class usage between penicillin-allergic and non-allergic patient cohorts.
• Assessment of risks for adverse events, including Clostridium difficile infection.

Main Results:

• Penicillin-allergic patients incurred an average lifetime antibiotic cost of $8171, versus $6278 for non-allergic patients, a difference of $1893.
• Penicillin-allergic individuals showed increased utilization of moderate-spectrum antibiotics and fluoroquinolones.
• A higher estimated risk of Clostridium difficile infection was observed in the penicillin-allergic group.

Conclusions:

• Penicillin allergy labels are associated with significantly higher lifetime antibiotic costs.
• Altered antibiotic prescribing patterns in penicillin-allergic patients may increase the risk of specific adverse events.
• Re-evaluation of penicillin allergy status and judicious antibiotic selection are warranted to mitigate costs and risks.