Readmission rates following removal of penicillin allergy label after inpatient penicillin allergy testing
Monday, March 5, 2018: 2:00 PM
S310AB (Convention Center)
Shyam R. Joshi, MD, , , , ,
RATIONALE: A penicillin allergy label has been reported to increase morbidity and hospital length of stay. More recently, the risk of readmission has been reported to be significantly higher in this population at 12 weeks from discharge. Evaluating for penicillin allergy can help remove this label which can be performed both inpatient or outpatient.

METHODS: Through an inpatient service at a large academic hospital, patients with a history of penicillin allergy were evaluated by a trained clinical pharmacist. If appropriate, penicillin skin testing and oral challenges were performed with the goal to remove inaccurate allergy labels. We evaluated readmission rates following removal of a penicillin allergy label in those with follow up ≥ 1 year after testing.

RESULTS: From November 2014 to April 2016, a total of 223 applicable charts were reviewed that completed inpatient penicillin testing. Forty-one of the 223 patients (18.4%) had a readmission within 30 days of their index admission compared to 8.9% for penicillin and non-penicillin allergic patients at the same hospital. The average rate of admissions 1 year prior to testing and 1 year after removal of the penicillin allergy label was not different (p=0.25).

CONCLUSIONS: No differences were seen in readmission rates prior to testing and after removal of the penicillin allergy label. The readmission rate remains higher for those with a history of a penicillin allergy label even after removal compared to the general population at 30 days. Inherent selection bias of patients with greater comorbidities to preferentially undergo inpatient penicillin testing may have affected the results.