88% With Penicillin Allergy Aren't Actually Allergic

About 88% of patients who had an allergy to penicillin listed on their electronic health record (EHR) weren’t actually allergic, according to new research.

To determine the rate of actual penicillin allergies, researchers recruited 135 inpatients with a listed penicillin allergy on their EHR who would likely benefit from penicillin therapy.
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Researchers first conducted a skin prick test and intradermal testing with benzylpenicilloyl polylsine. Only 2 patients were reactive to these tests.

In the remaining patients, researchers administered a penicillin G test with 500 mg of oral amoxicillin and observed each patient for 1 hour after administration.

After testing, researchers determined that 119 patients (88%) were able to tolerate penicillin antibiotics. Subsequently, those patients had the allergy removed from their EHR.

“An inpatient penicillin skin-testing protocol can lead to removing the penicillin allergy label in the vast majority of patients and serves to educate clinicians and patients alike,” researchers concluded. “Widespread implementation of this practice may potentially benefit healthcare systems by reducing the expense of alternative antibiotics and the risk of antimicrobial resistance.”

—Amanda Balbi

Reference:

Chen JR, Tarver SA, Alvarez KS, Tran T, Khan DA. Beneficial outcomes of an inpatient penicillin allergy testing protocol. J Allergy Clin Immunol. 2016; 137(2):AB91. Suppl. dx.doi.org/10.1016/j.jaci.2015.12.423.