Why Penicillin Allergy Testing?
Penicillin (PCN) Allergy Facts
Allergy to penicillin and related antibiotics is the most commonly reported drug allergy in the United States. It is estimated that 10% of patients, or 30 million people, self-report as being penicillin allergic; however, 9 out of 10 reporting penicillin allergy are not truly allergic when tested.1
- 9 out of 10 reporting penicillin allergy are not truly allergic.2
- 80% of patients with IgE-mediated penicillin allergy lose their sensitivity after 10 years.2
- Carrying an inaccurate diagnosis of penicillin "allergy" could adversely affect the quantity and quality of healthcare used.6
- Patients labeled penicillin-allergic have a threefold increased risk of adverse events (ADE).5
Penicillin Skin Testing (PST) Clinical Facts
Penicillin skin testing is a novel way to reduce use of broad spectrum antibiotics and can have a significant and immediate impact on antibiotic usage.
- The National Quality Partners’ Antibiotic Stewardship Action Team recommends penicillin allergy skin testing as a component of a comprehensive antibiotic stewardship program.8
- 98% of hospitalized subjects with a history of penicillin allergy would have negative results if tested.6
- PST frequently allowed for less expensive agents that would have been avoided due to a reported allergy.9
Antibiotic Resistance Facts
By some estimates, up to half of all hospitalized patients in the US receive antibiotics and up to half of antimicrobial use may be inappropriate.3 There is a causal relationship between inappropriate antimicrobial use and resistance; changes in antimicrobial use lead to parallel changes in the prevalence of resistance.4
- Since the discovery of penicillin, more than 100 antibiotic compounds have been introduced. But almost as soon as they were given to patients, scientists began finding evidence that disease-causing bacteria were developing resistance to these new wonder drugs.7
- The number of antibiotic-resistant bacteria continues to increase every year, while the number of antibiotics in the approval pipeline continues to decrease every year.7
Why Penicillin Allergy Testing?
Instructions for Supply Management and Test Preparation
Instructions for Conducting and Interpreting Penicillin Allergy Skin Testing
- 1. Salkind, Alan, R. et all. Is This Patient Allergic to Penicillin? JAMA, May 16, 2001 - Vol. 285, No. 19
- 2. Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273.
- 3. Owens, RC Jr., Fraser GL, Stogsdill P et al. Antimicrobial Stewardship Programs as a Means to Optimize Antimicrobial Use. Insights from the Society of Infectious Disease Pharmacists. Pharmacotherapy. 2004;24:896-908.
- 4. Dellit, TH, Owens, RC, McGowan JE, Jr et al. Infectious Disease Society of America and the Society for Healthcare Epidmiology of America Guidelines for Developing Institutional Programs to Enhance Antimicrobial Stewardship. Clin Infect Dis. 2007;44-150-77.
- 5. Blumenthal, Kimberly. Fortune Favors the Bold: Give a Beta-Lactam! Clinical infectious Diseases Advance Access. 2016 July.
- 6. Macy, Eric. Healthcare Use and Serious Infection Prevalence Associated with Penicillin "Allergy" in Hospitalized Patients: A Cohort Study. American Academy of Allergy, Asthma & Immunology. 2013.
- 7. Healy, Melissa. LA Times. A Slow Catastrophe Unfolds as the Golden Era of Antibiotics Comes to an End. July 11, 2016.
- 8. NQF Playbook & AAAAI Position Statement: Penicillin Allergy. https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/AAAAI-PAAR-position-statement-9-16.pdf. 2016.
- 9. Rimawi. The Impact of Penicillin Skin Testing on Clinical Practice and Antimicrobial Stewardship. 2013.