Who needs penicillin allergy testing?
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Multiple studies have described that persons with reported penicillin or another ß-lactam antibiotic allergy have higher rates of surgical-site infections, methicillin-resistant Staphylococcus aureus infections, and higher medical care usage.
“Multiple studies have described that persons with reported penicillin or another ß-lactam antibiotic allergy have higher rates of surgical-site infections, methicillin-resistant Staphylococcus aureus infections, and higher medical care usage (653,662–664).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [653]
The “Risks of Not Evaluating Individuals With a Penicillin Allergy” section reports more surgical-site infections when preferred penicillin prophylaxis is avoided, and longer hospital stays and increased hospital use among patients with reported penicillin allergy. It discusses poorer outcomes in methicillin-sensitive Staphylococcus aureus bacteremia, but does not report higher rates of methicillin-resistant S. aureus infections. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCross-reactivity between penicillin allergy and third-generation cephalosporins is low.
“even though the cross-reactivity between penicillin allergy and third-generation cephalosporins is low (652–654).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [653]
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Cites
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Flagged first, then by citations
Research works printed but not linked: 6
- Macy E, Contreras R. Healthcare utilization and serious infection prevalence associ- ated with penicillin "allergy" in hospitalized patients: a cohort study. J Allergy Clin Immunol. 2014;133:790-796.
- Macy E, Khan DA, Castells MC, Lang DM. Penicillin allergy testing: a key compo- nent of antibiotic stewardship. Clin Infect Dis. 2017;64:531-532.
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- Macy E, Ngor EW. Safely diagnosing clinically significant penicillin allergy using only penicilloyl-polylysine, penicillin, and oral amoxicillin. J Allergy Clin Immunol Pract. 2013;1:258-263.
- Marwood J, Aguirre-Barrena G, Kerr S, Welch SA, Rimmer J. De-labeling self- reported penicillin allergy within the emergency department through the use of skin tests and oral drug provocation testing. Emerg Med Australasia. 2017;29:509- 515.
- Park MA, Solensky R, Khan DA, Castells MC, Macy EM, Lang DM. Patient with posi- tive skin test results to penicillin should not undergo penicillin or amoxicillin chal- lenge. J Allergy Clin Immunol. 2015;135:816-817.
Cited by
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Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 2,759 · see citing works
- Authors
- Macy, E., & Vyles, D.
- Affiliations
- Kaiser Permanente (US)
- Medical College of Wisconsin (US)
- Corresponding author
- Macy, Eric
- Venue
- Annals of Allergy, Asthma & Immunology
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 121
- Issue
- 5
- Pages
- 523-529
- ISSN
- 1081-1206 (ISSN-L)
- OpenAlex
- W2885204219
- Cited by
- 76
- References
- 57
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 15 · 2023: 8 · 2022: 7 · 2021: 7 · 2020: 18 · 2019: 12 · 2018: 1
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Allergy Asthma & Immunology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Surgery › Surgical site infection prevention
- Keywords
- penicillin allergy, allergy testing, antibiotic allergy labeling, electronic health records, antibiotic avoidance, drug hypersensitivity
- MeSH terms
- Anti-Bacterial Agents, Drug Hypersensitivity, Humans, Penicillins, Predictive Value of Tests, Skin Tests
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