Rates of Antibiotic-Associated Infections in Patients Following Removal of their Penicillin Allergy Label
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Shazia Lutfeali, MD, Scott A. Tarver, PharmD, Kristin Alvarez, Associate Director Pharmacy, Belinda Mang, Clinical Pharmacist, Wenjing Wei, Clinical Pharmacy Specialist, David A. Khan, MD FAAAAI
RATIONALE: Most patients labeled with penicillin “allergy” are not in fact allergic. A 2014 study by Macy et al. found hospitalized patients labeled with penicillin allergy have increased rates of infections compared to controls for infections such as C difficile (2.9% vs 2.4%), MRSA (3.0% vs 2.6%), and VRE (0.6% vs 0.5%).

METHODS: We reviewed a database of patients from Parkland Memorial Hospital who had undergone inpatient penicillin skin testing and challenge as part of a proactive testing program. Patients with negative tests had their penicillin allergy removed from their charts. Rates of infection with C difficile, MRSA, and VRE up to 90 days after penicillin testing (highest rate of C difficile occurrence) was assessed by review of the EMR.

RESULTS: A total of 223 patients with negative penicillin tests were evaluated who had at least 90 days of follow-up data. Five patients (2.2%) developed C difficile infections in the 90 day period post testing; five patients (2.2%) developed MRSA infections, and another 5 patients (2.2%) developed VRE infections.

CONCLUSIONS: Rates of C. difficile and MRSA in hospitalized patients who had removal of their penicillin allergy are comparable to those reported in patients without penicillin allergy.