Health care use and serious infection prevalence associated with penicillin “allergy” in hospitalized patients: A cohort study.
Abstract
Background Penicillin is the most common drug "allergy" noted at hospital admission, although it is often inaccurate.Objective We sought to determine total hospital days, antibiotic exposures, and the prevalence rates of Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) in patients with and without penicillin "allergy" at hospital admission.Methods We performed a retrospective, matched cohort study of subjects admitted to Kaiser Foundation hospitals in Southern California during 2010 through 2012.Results It was possible to match 51,582 (99.6% of all possible cases) unique hospitalized subjects with penicillin "allergy" to 2 unique discharge diagnosis category-matched, sex-matched, age-matched, and date of admission-matched control subjects each. Cases with penicillin "allergy" averaged 0.59 (9.9%; 95% CI, 0.47-0.71) more total hospital days during 20.1 ± 10.5 months of follow-up compared with control subjects. Cases were treated with significantly more fluoroquinolones, clindamycin, and vancomycin (P < .0001) for each antibiotic compared with control subjects. Cases had 23.4% (95% CI, 15.6% to 31.7%) more C difficile, 14.1% (95% CI, 7.1% to 21.6%) more MRSA, and 30.1% (95% CI, 12.5% to 50.4%) more VRE infections than expected compared with control subjects.Conclusions A penicillin "allergy" history, although often inaccurate, is not a benign finding at hospital admission. Subjects with a penicillin "allergy" history spend significantly more time in the hospital. Subjects with a penicillin "allergy" history are exposed to significantly more antibiotics previously associated with C difficile and VRE. Drug "allergies" in general, but most those notably to penicillin, are associated with increased hospital use and increased C difficile, MRSA, and VRE prevalence.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
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 [662]
Cites
Drug Allergy: An Updated Practice Parameter
(2010) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2010.08.002 · Cited by 954 · see citing works
Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics
Hensgens, M. P. M., Goorhuis, A., Dekkers, O. M., & Kuijper, E. J. (2011) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkr508 · Cited by 400 · see citing works
Antibiotic prescribing in hospitals: a social and behavioural scientific approach
Hulscher, M., Grol, R. P. T. M., & van der Meer, J. W. M. (2010) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(10)70027-x · Cited by 363 · see citing works
Self-reported antibiotic allergy incidence and prevalence: age and sex effects.
Macy, E., & Poon K-Y, T. (2009) · The American Journal of Medicine · doi:10.1016/j.amjmed.2009.01.034 · Cited by 313 · see citing works
Macy, E., & Ngor, E. W. (2013) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2013.02.002 · Cited by 275 · see citing works
Solensky, R., Earl, H. S., & Gruchalla, R. S. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.7.822 · Cited by 173 · see citing works
Multiple drug intolerance syndrome: prevalence, clinical characteristics, and management
Macy, E. M., & Ho, N. J. (2011) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2011.11.006 · Cited by 171 · see citing works
Hypersensitivity Reactions to Beta-Lactam Antibiotics
Solensky, R. (2003) · Clinical Reviews in Allergy & Immunology · doi:10.1385/criai:24:3:201 · Cited by 144 · see citing works
The impact of penicillin skin testing on clinical practice and antimicrobial stewardship
Rimawi, R. H., Cook, P., Gooch, M. D., Kabchi, B. A., Ashraf, M. S., Rimawi, B. H., Gebregziabher, M., & Siraj, D. S. (2013) · Journal of Hospital Medicine · doi:10.1002/jhm.2036 · Cited by 141 · see citing works
Park, M., Markus, P. J., Matešić, D., & Li, J. T. C. (2006) · Annals of Allergy Asthma & Immunology · doi:10.1016/s1081-1206(10)61100-3 · Cited by 133 · see citing works
Macy, E. M., Mangat, R., & Burchette, R. J. (2003) · Journal of Allergy and Clinical Immunology · doi:10.1067/mai.2003.1385 · Cited by 120 · see citing works
The Falling Rate of Positive Penicillin Skin Tests from 1995 to 2007
Macy, E. M., Schatz, M. N., Lin, C., & Poon, K. T. (2009) · The Permanente Journal · doi:10.7812/tpp/08-073 · Cited by 115 · see citing works
Macy, E. M., Goldberg, B. J., & Poon, K. T. (2010) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2010.06.014 · Cited by 104 · see citing works
Macy, E. M. (2006) · Annals of Allergy Asthma & Immunology · doi:10.1016/s1081-1206(10)60007-5 · Cited by 91 · see citing works
Medical Care Costs Associated With Progression of Diabetic Nephropathy
Nichols, G. A., Vupputuri, S. X., & Lau, H. (2011) · Diabetes Care · doi:10.2337/dc11-0475 · Cited by 81 · see citing works
Penicillin Skin Testing: Potential Implications for Antimicrobial Stewardship
Unger, N. R., Gauthier, T. P., & Cheung, L. (2013) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/phar.1288 · Cited by 79 · see citing works
Reduction of Vancomycin Use in Orthopedic Patients With a History of Antibiotic Allergy
Li, J. T. C., Markus, P. J., Osmon, D. R., Estes, L. L., Gosselin, V. A., & Hanssen, A. D. (2000) · Mayo Clinic Proceedings · doi:10.4065/75.9.902 · Cited by 78 · see citing works
Arroliga, M. E., Wagner, W. O., Bobek, M. B., Hoffman-Hōgg, L., Gordon, S. M., & Arroliga, A. C. (2000) · CHEST Journal · doi:10.1378/chest.118.4.1106 · Cited by 76 · see citing works
Arroliga, M. E., Radojicic, C., Gordon, S. M., Popovich, M. J., Bashour, C. A., Melton, A. L., & Arroliga, A. C. (2003) · Infection Control and Hospital Epidemiology · doi:10.1086/502212 · Cited by 69 · see citing works
Forrest, D. M., Schellenberg, R. R., Thien, V., King, S., Anis, A. H., & Dodek, P. (2001) · Clinical Infectious Diseases · doi:10.1086/320752 · Cited by 53 · see citing works
Frigas, E., Park, M. A., Narr, B. J., Volcheck, G. W., Danielson, D. R., Markus, P. J., Olson, K. E. K., Schroeder, D. R., & Kita, H. (2008) · Mayo Clinic Proceedings · doi:10.4065/83.6.651 · Cited by 46 · see citing works
Adverse Reactions Associated with Therapeutic Antibiotic Use after Penicillin Skin Testing
Macy, E. M., & Ho, N. J. (2011) · The Permanente Journal · doi:10.7812/tpp/11-025 · Cited by 42 · see citing works
Kuntz, J. L., Johnson, E. S., Raebel, M. A., Petrik, A. F., Yang, X., Thorp, M. L., Spindel, S. J., Neil, N., & Smith, D. H. (2012) · Infection Control and Hospital Epidemiology · doi:10.1086/667733 · Cited by 39 · see citing works
Management of group B Streptococcus in pregnant women with penicillin allergy.
Philipson, E. H., Lang, D. M., Gordon, S. J., Burlingame, J. M., Emery, S. P., & Arroliga, M. E. (2007) · PubMed · Cited by 35 · see citing works
Warrington, R., Lee, K. R., & McPhillips, S. (2000) · Allergy and Asthma Proceedings · doi:10.2500/108854100778248269 · Cited by 35 · see citing works
Asthma costs and utilization in a managed care organization
Zeiger, R. S., Hay, J. W., Contreras, R., Chen, W., Quinn, V. P., Seal, B. S., & Schatz, M. N. (2008) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2007.12.1178 · Cited by 35 · see citing works
Macy, E. M. (2011) · Clinical & Experimental Allergy · doi:10.1111/j.1365-2222.2011.03837.x · Cited by 31 · see citing works
Macy, E. M. (2004) · The Permanente Journal · doi:10.7812/tpp/04.934 · Cited by 29 · see citing works
Recommendations for the Management of Beta-Lactam Intolerance
Macy, E. M., & Ngor, E. W. M. (2013) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-013-8369-8 · Cited by 28 · see citing works
Reddy, V., Baman, N., Whitener, C., & Ishmael, F. T. (2013) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2012.12.1269 · Cited by 19 · see citing works
Routine Penicillin Skin Testing in Hospitalized Patients with a History of Penicillin Allergy
Macy, E., Roppe, L. B., & Schatz, M. (2004) · Europe PMC (PubMed Central) · Cited by 19 · see citing works
Creating Standard Cost Measures Across Integrated Health Care Delivery Systems
Ritzwoller, D. P. (2005) · JNCI Monographs · doi:10.1093/jncimonographs/lgi043 · Cited by 18 · see citing works
Multihospital Outbreak ofClostridium difficileInfection, Cleveland, Ohio, USA
Jump, R., Riggs, M. M., Sethi, A. K., Pultz, M. J., Ellis-Reid, T., Riebel, W. J., Gerding, D. N., Salata, R. A., & Donskey, C. J. (2010) · Emerging infectious diseases · doi:10.3201/eid1605.071606 · Cited by 14 · see citing works
Flagged first, then by citations
1 of the 34 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Barlam, T. F., Cosgrove, S. E., Abbo, L. M., MacDougall, C., Schuetz, A. N., Septimus, E. J., Srinivasan, A., Dellit, T. H., Falck-Ytter, Y. T., Fishman, N. O., et al. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/ciw118 · Cited by 3,147 · see citing works
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
Evaluation and Management of Penicillin Allergy: A Review
Shenoy, E. S., Macy, E., Rowe, T., & Blumenthal, K. G. (2019) · JAMA · doi:10.1001/jama.2018.19283 · Cited by 830 · see citing works
Blumenthal, K. G., Peter, J. G., Trubiano, J. A., & Phillips, E. J. (2019) · The Lancet · doi:10.1016/s0140-6736(18)32218-9 · Cited by 614 · see citing works
2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines
Simons, F. E. R., Ebisawa, M., Sánchez‐Borges, M., Thong, B. Y., Worm, M., Tanno, L. K., Lockey, R. F., El‐Gamal, Y., Brown, S. G. A., Park, H., et al. (2015) · World Allergy Organization Journal · doi:10.1186/s40413-015-0080-1 · Cited by 591 · see citing works
Drug allergy: A 2022 practice parameter update
Khan, D. A., Banerji, A., Blumenthal, K. G., Phillips, E. J., Solensky, R., White, A. A., Bernstein, J. A., Chu, D. K., Ellis, A. K., Golden, D. B. K., et al. (2022) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2022.08.028 · Cited by 572 · see citing works
Harper, N. J. N., Cook, T. M., Garcez, T. P., Farmer, L., Floss, K., Marinho, S., Torevell, H. E., Warner, A., Ferguson, K., Hitchman, J., et al. (2018) · British Journal of Anaesthesia · doi:10.1016/j.bja.2018.04.014 · Cited by 524 · see citing works
The impact of a reported penicillin allergy on surgical site infection risk.
Blumenthal, K. G., Ryan, E. E., Li, Y., Lee, H., Kuhlen, J. L., & Shenoy, E. S. (2018) · Clinical Infectious Diseases · doi:10.1093/cid/cix794 · Cited by 481 · see citing works
2017 EACTS Guidelines on perioperative medication in adult cardiac surgery
Sousa‐Uva, M., Head, S. J., Milojevic, M., Collet, J., Landoni, G., Castellà, M., Dunning, J., Guðbjartsson, T., Linker, N., Sandoval, E., et al. (2017) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezx314 · Cited by 402 · see citing works
Development and Validation of a Penicillin Allergy Clinical Decision Rule
Trubiano, J. A., Vogrin, S., Chua, K., Bourke, J., Yun, J. J., Douglas, A. P., Stone, C. A., Yu, R. J., Groenendijk, L., Holmes, N. E., et al. (2020) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2020.0403 · Cited by 393 · see citing works
Towards a more precise diagnosis of hypersensitivity to beta‐lactams — an EAACI position paper
Romano, A. G., Atanasković‐Marković, M., Barbaud, A. M., Bircher, A. J., Brockow, K., Caubet, J., Çelík, G., Cernadas, J., Chiriac, A. M., Demoly, P. M., et al. (2019) · Allergy · doi:10.1111/all.14122 · Cited by 363 · see citing works
Blumenthal, K. G., Lu, N., Zhang, Y., Li, Y., Walensky, R. P., & Choi, H. K. (2018) · BMJ · doi:10.1136/bmj.k2400 · Cited by 357 · see citing works
Impact of Reported Beta-Lactam Allergy on Inpatient Outcomes: A Multicenter Prospective Cohort Study
MacFadden, D. R., Delfa, A. L., Leen, J., Gold, W. L., Daneman, N., Weber, E., Al-Busaidi, I. S., Petrescu, D., Saltzman, I., Devlin, M. K., et al. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/ciw462 · Cited by 297 · see citing works
Management of allergy to penicillins and other beta‐lactams
Mirakian, R. M., Leech, S. C., Krishna, M. T., Richter, A. G., Huber, P. A. J., Farooque, S. P., Khan, N., Pirmohamed, M., Clark, A. T., & Nasser, S. M. (2015) · Clinical & Experimental Allergy · doi:10.1111/cea.12468 · Cited by 288 · see citing works
Sacco, K. A., Bates, A., Brigham, T., Imam, J. S., & Burton, M. C. (2017) · Allergy · doi:10.1111/all.13168 · Cited by 284 · see citing works
Castells, M., Khan, D. A., & Phillips, E. J. (2019) · New England Journal of Medicine · doi:10.1056/nejmra1807761 · Cited by 278 · see citing works
Penicillin and Beta-Lactam Allergy: Epidemiology and Diagnosis
Macy, E. M. (2014) · Current Allergy and Asthma Reports · doi:10.1007/s11882-014-0476-y · Cited by 271 · see citing works
The challenge of de‐labeling penicillin allergy
Stone, C. A., Trubiano, J. A., Coleman, D. T., Rukasin, C. R. F., & Phillips, E. J. (2019) · Allergy · doi:10.1111/all.13848 · Cited by 270 · see citing works
Practical Guidance for the Evaluation and Management of Drug Hypersensitivity: Specific Drugs
Broyles, A. D., Banerji, A., Barmettler, S., Biggs, C. M., Blumenthal, K. G., Brennan, P. J., Breslow, R. G., Brockow, K., Buchheit, K. M., Cahill, K. N., et al. (2020) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2020.08.006 · Cited by 248 · see citing works
Penicillin Allergy Is Not Necessarily Forever
Trubiano, J. A., Adkinson, N. F., & Phillips, E. J. (2017) · JAMA · doi:10.1001/jama.2017.6510 · Cited by 200 · see citing works
Olans, R. N., Olans, R. D., & DeMaria, A. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/civ697 · Cited by 190 · see citing works
Blumenthal, K. G., Shenoy, E. S., Varughese, C. A., Hurwitz, S., Hooper, D. C., & Banerji, A. (2015) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2015.05.011 · Cited by 185 · see citing works
Incidence and nature of adverse reactions to antibiotics used as endocarditis prophylaxis
Thornhill, M. H., Dayer, M., Prendergast, B., Baddour, L. M., Jones, S., & Lockhart, P. B. (2015) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkv115 · Cited by 180 · see citing works
Chua, K., Vogrin, S., Bury, S., Douglas, A. P., Holmes, N. E., Tan, N., Brusco, N. K., Hall, R., Lambros, B., Lean, J., et al. (2020) · Clinical Infectious Diseases · doi:10.1093/cid/ciaa653 · Cited by 171 · see citing works
Albin, S., & Agarwal, S. (2014) · Allergy and Asthma Proceedings · doi:10.2500/aap.2014.35.3791 · Cited by 162 · see citing works
Safety and outcomes of oral graded challenges to amoxicillin without prior skin testing.
Iammatteo, M., Alvarez Arango, S., Ferastraoaru, D., Akbar, N., Lee, A. Y., Cohen, H. W., & Jerschow, E. (2019) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2018.05.008 · Cited by 157 · see citing works
Consequences of avoiding β-lactams in patients with β-lactam allergies
Jeffres, M. N., Narayanan, P. P., Shuster, J. E., & Schramm, G. E. (2015) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2015.10.026 · Cited by 154 · see citing works
Macy, E., & Contreras, R. (2015) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2014.07.062 · Cited by 153 · see citing works
Improving the Effectiveness of Penicillin Allergy De-labeling
Bourke, J., Pavlos, R. K., JAMES, I. R., & Phillips, E. J. (2015) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2014.11.002 · Cited by 153 · see citing works
A proactive approach to penicillin allergy testing in hospitalized patients.
Chen, J. R., Tarver, S. A., Alvarez, K. S., Tran, T., & Khan, D. A. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2016.09.045 · Cited by 152 · see citing works
The Cost of Self-Reported Penicillin Allergy: A Systematic Review
Mattingly, T. J., Fulton, A. B., Lumish, R., Williams, A. M., Yoon, S., Yuen, M., & Heil, E. L. (2018) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2017.12.033 · Cited by 148 · see citing works
Trubiano, J. A., Chen, C., Cheng, A. C., Grayson, M. L., Slavin, M. A., & Thursky, K. (2016) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkw008 · Cited by 147 · see citing works
Tackling inpatient penicillin allergies: Assessing tools for antimicrobial stewardship
Blumenthal, K. G., Wickner, P. G., Hurwitz, S., Pricco, N., Nee, A. E., Laskowski, K. R., Shenoy, E. S., & Walensky, R. P. (2017) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2017.02.005 · Cited by 146 · see citing works
Cephalosporins: A Focus on Side Chains and β-Lactam Cross-Reactivity
Chaudhry, S. B., Veve, M. P., & Wagner, J. L. (2019) · Pharmacy · doi:10.3390/pharmacy7030103 · Cited by 146 · see citing works
Tucker, M. H., Lomas, C. M., Ramchandar, N., & Waldram, J. D. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2017.01.023 · Cited by 141 · see citing works
Trubiano, J. A., Thursky, K. A., Stewardson, A. J., Urbancic, K., Worth, L. J., Jackson, C., Stevenson, W., Sutherland, M., Slavin, M. A., Grayson, M. L., et al. (2017) · Clinical Infectious Diseases · doi:10.1093/cid/cix244 · Cited by 137 · see citing works
Antibiotic Allergy in Pediatrics
Norton, A. E., Konvinse, K. C., Phillips, E. J., & Broyles, A. D. (2018) · PEDIATRICS · doi:10.1542/peds.2017-2497 · Cited by 132 · see citing works
West, R. M., Smith, C., Pavitt, S. H., Butler, C., Howard, P., Bates, C. J., Savic, S., Wright, J. M., Hewison, J., & Sandoe, J. A. T. (2019) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkz127 · Cited by 130 · see citing works
Frequency of self-reported drug allergy: A systematic review and meta-analysis with meta-regression.
Sousa-Pinto, B., Fonseca, J., & Gomes, E. (2017) · Annals of Allergy, Asthma & Immunology · doi:10.1016/j.anai.2017.07.009 · Cited by 122 · see citing works
Controversies in Drug Allergy: Beta-Lactam Hypersensitivity Testing
Torres, M. J., Adkinson, N. F., Caubet, J., Khan, D. A., Kidon, M. I., Mendelson, L. M., Gomes, E. R., Rerkpattanapipat, T., Zhang, S., & Macy, E. M. (2018) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2018.07.051 · Cited by 127 · see citing works
Penicillin skin testing in hospitalized patients with β-lactam allergies
King, E. A., Challa, S., Curtin, P., & Bielory, L. (2016) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2016.04.021 · Cited by 125 · see citing works
The Cost of Penicillin Allergy Evaluation
Blumenthal, K. G., Li, Y., Banerji, A., Yun, B. J., Long, A. A., & Walensky, R. P. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2017.08.006 · Cited by 125 · see citing works
Huang, K. G., Cluzet, V. C., Hamilton, K. W., & Fadugba, O. O. (2018) · Clinical Infectious Diseases · doi:10.1093/cid/ciy037 · Cited by 126 · see citing works
Picard, M., Robitaille, G., Karam, F., Daigle, J.-M., Bédard, F., Biron, É., Tardif, M. R., Lacombe‐Barrios, J., & Bégin, P. (2019) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2019.05.038 · Cited by 125 · see citing works
The High Impact of Penicillin Allergy Registration in Hospitalized Patients
van Dijk, S. M., Gardarsdóttir, H., Wassenberg, M. W. M., Oosterheert, J. J., de Groot, M., & Röckmann, H. (2016) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2016.03.009 · Cited by 119 · see citing works
Mustafa, S. S., Conn, K. M., & Ramsey, A. C. (2019) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2019.05.037 · Cited by 119 · see citing works
Implementation of a pharmacist-led penicillin allergy de-labelling service in a public hospital.
du Plessis, T., Walls, G., Jordan, A., & Holland, D. J. (2019) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dky575 · Cited by 117 · see citing works
Penicillin and Cephalosporin allergy
Pichichero, M. E., & Zagursky, R. J. (2014) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2014.02.005 · Cited by 117 · see citing works
Menz, B. D., Charani, E., Gordon, D. L., Leather, A. J., Moonesinghe, S. R., & Phillips, C. J. (2021) · Infection and Drug Resistance · doi:10.2147/idr.s319780 · Cited by 118 · see citing works
Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation
Blumenthal, K. G., Shenoy, E. S., Wolfson, A. R., Berkowitz, D. N., Carballo, V. A., Balekian, D. S., Marquis, K. A., Elshaboury, R. H., Gandhi, R. G., Meka, P., et al. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2017.02.019 · Cited by 116 · see citing works
The Effect of Penicillin Allergy Testing on Future Health Care Utilization: A Matched Cohort Study
Macy, E. M., & Shu, Y. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2017.02.012 · Cited by 113 · see citing works
Li, M., Krishna, M. T., Razaq, S., & Pillay, D. (2014) · Journal of Clinical Pathology · doi:10.1136/jclinpath-2014-202438 · Cited by 112 · see citing works
Penicillin Allergy Delabeling: A Multidisciplinary Opportunity
Staicu, M. L., Vyles, D. E., Shenoy, E. S., Stone, C. A., Banks, T. A., Alvarez, K., & Blumenthal, K. G. (2020) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2020.04.059 · Cited by 115 · see citing works
Devchand, M., Kirkpatrick, C. M. J., Stevenson, W., Garrett, K., Perera, D., Khumra, S., Urbancic, K. F., Grayson, M. L., & Trubiano, J. A. (2019) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkz082 · Cited by 105 · see citing works
Practical Guidance for the Evaluation and Management of Drug Hypersensitivity: General Concepts
Broyles, A. D., Banerji, A., & Castells, M. (2020) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2020.08.002 · Cited by 100 · see citing works
The 3 Cs of Antibiotic Allergy—Classification, Cross-Reactivity, and Collaboration
Trubiano, J. A., Stone, C. A., Grayson, M. L., Urbancic, K. F., Slavin, M. A., Thursky, K., & Phillips, E. J. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2017.06.017 · Cited by 98 · see citing works
2024 EACTS Guidelines on perioperative medication in adult cardiac surgery
Jeppsson, A., (Sweden), (.-C., Rocca, B., (Italy), (.-C., Hansson, E. C., (Sweden), Guðbjartsson, T., (Iceland), James, S. K., (Sweden), et al. (2024) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezae355 · Cited by 107 · see citing works
Documenting Penicillin Allergy: The Impact of Inconsistency
Shah, N. S., Ridgway, J. P., Pettit, N. N., Fahrenbach, J. P., & Robicsek, A. A. (2016) · PLoS ONE · doi:10.1371/journal.pone.0150514 · Cited by 98 · see citing works
Risk of Adverse Reactions to Oral Antibiotics Prescribed by Dentists
Thornhill, M. H., Dayer, M., Durkin, M. J., Lockhart, P. B., & Baddour, L. M. (2019) · Journal of Dental Research · doi:10.1177/0022034519863645 · Cited by 96 · see citing works
Penicillin Allergy Testing Is Cost-Saving: An Economic Evaluation Study
Sousa‐Pinto, B., Blumenthal, K. G., Macy, E. M., Pereira, A. M., Azevedo, L. F., Delgado, L., & Fonseca, J. (2020) · Clinical Infectious Diseases · doi:10.1093/cid/ciaa194 · Cited by 96 · see citing works
Clinical Decision Support Systems for Drug Allergy Checking: Systematic Review
Légat, L., Laere, S. V., Nyssen, M., Steurbaut, S., Dupont, A. G., & Cornu, P. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.8206 · Cited by 91 · see citing works
Wunderink, R. G., Srinivasan, A., Barie, P. S., Chastre, J. E., Cruz, C. S. D., Douglas, I. S., Ecklund, M. M., Evans, S. E., Evans, S. R., Gerlach, A. T., et al. (2020) · Annals of the American Thoracic Society · doi:10.1513/annalsats.202003-188st · Cited by 94 · see citing works
Lang, D. M., Castells, M., Khan, D. A., Macy, E. M., & Murphy, A. W. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2016.12.010 · Cited by 92 · see citing works
Evaluating Penicillin Allergies Without Skin Testing
Banks, T. A., Tucker, M. H., & Macy, E. M. (2019) · Current Allergy and Asthma Reports · doi:10.1007/s11882-019-0854-6 · Cited by 91 · see citing works
Identifying low-risk beta-lactam allergy patients in a UK tertiary centre.
Siew, L. Q. C., Li, P. H., Watts, T. J., Thomas, I., Ue, K. L., Caballero, M. R., Rutkowski, K., Till, S. J., Pillai, P., & Haque, R. (2019) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2019.03.015 · Cited by 89 · see citing works
Blumenthal, K. G., Parker, R. A., Shenoy, E. S., & Walensky, R. P. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/civ394 · Cited by 89 · see citing works
Junior, P. F. G.-B., Galvão, V. R., Picard, M., Caiado, J., & Castells, M. (2016) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2016.11.006 · Cited by 89 · see citing works
Savic, L. C., Ardern‐Jones, M. R., Avery, A. J., Cook, T., Denman, S., Farooque, S. P., Garcez, T. P., Gold, R., Jay, N., Krishna, M. T., et al. (2022) · Clinical & Experimental Allergy · doi:10.1111/cea.14217 · Cited by 88 · see citing works
Antibiotic Allergy Labels in Children Are Associated with Adverse Clinical Outcomes
Lucas, M., Arnold, A., Sommerfield, A., Trevenen, M., Braconnier, L., Schilling, A., Abass, F. A., Slevin, L., Knezevic, B., Blyth, C. C., et al. (2018) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2018.09.003 · Cited by 87 · see citing works
Practical Management of Antibiotic Hypersensitivity in 2017
Macy, E. M., Romano, A. G., & Khan, D. A. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2017.02.014 · Cited by 85 · see citing works
Inglis, J. M., Caughey, G. E., Smith, W., & Shakib, S. (2017) · Internal Medicine Journal · doi:10.1111/imj.13558 · Cited by 84 · see citing works
Enhancing antibiotic stewardship by tackling “spurious” penicillin allergy
Krishna, M. T., Huissoon, A. P., Li, M., Richter, A. G., Pillay, D. G., Sambanthan, D., Raman, S. C., Nasser, S. M., & Misbah, S. (2017) · Clinical & Experimental Allergy · doi:10.1111/cea.13044 · Cited by 84 · see citing works
Powell, N., Stephens, J., Kohl, D., Owens, R., Ahmed, S., Musicha, C., Upton, M., Kent, B., Tonkin-Crine, S. K., & Sandoe, J. A. T. (2022) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2022.11.026 · Cited by 83 · see citing works
Antimicrobial Stewardship in the Hospital Setting: A Narrative Review
Giamarellou, H., Galani, L., Karavasilis, T., Ioannidis, K., & Karaiskos, I. (2023) · Antibiotics · doi:10.3390/antibiotics12101557 · Cited by 91 · see citing works
Penicillin Allergy Assessment in Pregnancy: Safety and Impact on Antibiotic Use
Wolfson, A. R., Mancini, C. M., Banerji, A., Fu, X., Bryant, A., Phadke, N. A., Shenoy, E. S., Arman, W., Zhang, Y., & Blumenthal, K. G. (2020) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2020.10.063 · Cited by 80 · see citing works
Desai, S. H., Kaplan, M., Chen, Q., & Macy, E. M. (2017) · The Permanente Journal · doi:10.7812/tpp/16-080 · Cited by 79 · see citing works
Are Cephalosporins Safe for Use in Penicillin Allergy without Prior Allergy Evaluation?
Macy, E. M., & Blumenthal, K. G. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2017.07.033 · Cited by 79 · see citing works
Trubiano, J. A., Cairns, K. A., Evans, J. A., Ding, A., Nguyen, T., Dooley, M. J., & Cheng, A. C. (2015) · BMC Infectious Diseases · doi:10.1186/s12879-015-1303-3 · Cited by 79 · see citing works
Risk-stratified Management to Remove Low-Risk Penicillin Allergy Labels in the ICU
Stone, C. A., Stollings, J. L., Lindsell, C. J., Dear, M. L., Buie, R. B., Rice, T. W., & Phillips, E. J. (2020) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202001-0089le · Cited by 76 · see citing works
Who needs penicillin allergy testing?
Macy, E., & Vyles, D. (2018) · Annals of Allergy, Asthma & Immunology · doi:10.1016/j.anai.2018.07.041 · Cited by 76 · see citing works
Lymphocyte transformation test: History and current approaches
Sachs, B., Fatangare, A., Sickmann, A., & Glässner, A. (2021) · Journal of Immunological Methods · doi:10.1016/j.jim.2021.113036 · Cited by 75 · see citing works
Guidelines on Implementing Antimicrobial Stewardship Programs in Korea
Yoon, Y. K., Kwon, K. T., Jeong, S. J., Moon, C., Kim, B., Kiem, S., Kim, H.-S., Heo, E., Kim, S., Korean Society for Antimicrobial Therapy, et al. (2021) · Infection and Chemotherapy · doi:10.3947/ic.2021.0098 · Cited by 74 · see citing works
Ramsey, A. C., & Staicu, M. L. (2017) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2017.11.012 · Cited by 71 · see citing works
The Value of In Vitro Tests to Diminish Drug Challenges
Mayorga, C., Doña, I., Pérez‐Inestrosa, E., Fernández, T. D., & Torres, M. J. (2017) · International Journal of Molecular Sciences · doi:10.3390/ijms18061222 · Cited by 72 · see citing works
Macy, E. M. (2015) · Current Opinion in Allergy and Clinical Immunology · doi:10.1097/aci.0000000000000173 · Cited by 72 · see citing works
Penicillin allergy de-labelling ahead of elective surgery: feasibility and barriers
Savic, L. C., Gurr, L., Kaura, V., Toolan, J., Sandoe, J. A. T., Hopkins, P. M., & Savic, S. (2018) · British Journal of Anaesthesia · doi:10.1016/j.bja.2018.09.009 · Cited by 71 · see citing works
Trubiano, J. A., Beekmann, S. E., Worth, L. J., Polgreen, P. M., Thursky, K., Slavin, M. A., Grayson, M. L., & Phillips, E. J. (2016) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofw153 · Cited by 71 · see citing works
Solensky, R., Jacobs, J., Lester, M., Lieberman, P., McCafferty, F., Nilsson, T., Park, M., Schwarz, G., Soong, W., Wagelie-Steffen, A., et al. (2019) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2019.02.040 · Cited by 70 · see citing works
The revolving door: antibiotic allergy labelling in a tertiary care centre
Knezevic, B., Sprigg, D., Seet, J., Trevenen, M., Trubiano, J. A., Smith, W., Jeelall, Y. S., Vale, S., Loh, R., McLean‐Tooke, A. P., et al. (2016) · Internal Medicine Journal · doi:10.1111/imj.13223 · Cited by 70 · see citing works
Macy, E. M., McCormick, T. A., Adams, J., Crawford, W., Nguyen, M. T., Hoang, L., Eng, V., Davis, A., & McGlynn, E. A. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.8367 · Cited by 69 · see citing works
Powell, N., Honeyford, K., & Sandoe, J. A. T. (2020) · Journal of Hospital Infection · doi:10.1016/j.jhin.2020.05.042 · Cited by 68 · see citing works
Krah, N. M., Jones, T. W., Lake, J., & Hersh, A. L. (2020) · Infection Control and Hospital Epidemiology · doi:10.1017/ice.2020.1229 · Cited by 68 · see citing works
Jeimy, S. B., Ben‐Shoshan, M., Abrams, E. M., Ellis, A. K., Connors, L. A., & Wong, T. (2020) · Allergy Asthma and Clinical Immunology · doi:10.1186/s13223-020-00494-2 · Cited by 68 · see citing works
Misconceptions Surrounding Penicillin Allergy: Implications for Anesthesiologists
Vorobeichik, L., Weber, E., & Tarshis, J. (2018) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000003419 · Cited by 68 · see citing works
The impact of antimicrobial allergy labels on antimicrobial usage in cancer patients
Trubiano, J. A., Leung, V. K. Y., Chu, M. Y., Worth, L. J., Slavin, M. A., & Thursky, K. (2015) · Antimicrobial Resistance and Infection Control · doi:10.1186/s13756-015-0063-6 · Cited by 67 · see citing works
Controversies in Drug Allergy: Drug Allergy Pathways
Chiriac, A. M., Banerji, A., Gruchalla, R. S., Thong, B. Y., Wickner, P. G., Mertès, P., Terreehorst, I., & Blumenthal, K. G. (2018) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2018.07.037 · Cited by 66 · see citing works
Clinical and economic burden of hospitalizations with registration of penicillin allergy
Sousa‐Pinto, B., Cardoso‐Fernandes, A., Araújo, L. M., Fonseca, J., Freitas, A., & Delgado, L. (2018) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2017.11.022 · Cited by 65 · see citing works
Abrams, E. M., Wakeman, A., Gerstner, T. V., Warrington, R., & Singer, A. G. (2016) · Allergy Asthma and Clinical Immunology · doi:10.1186/s13223-016-0165-6 · Cited by 64 · see citing works
Stevenson, B. R., Trevenen, M., Klinken, E., Smith, W., Yuson, C., Katelaris, C. H., Perram, F., Burton, P. K., Yun, J. J., Cai, F., et al. (2019) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2019.09.025 · Cited by 63 · see citing works
Antibiotic Use After Removal of Penicillin Allergy Label
Vyles, D. E., Chiu, A. M., Routes, J. M., Castells, M., Phillips, E. J., Kibicho, J. W., & Brousseau, D. C. (2018) · PEDIATRICS · doi:10.1542/peds.2017-3466 · Cited by 62 · see citing works
- Authors
- Macy, E., & Contreras, R.
- Affiliations
- Kaiser Permanente (US)
- Corresponding author
- Macy, Eric
- ORCID
- Macy, Eric
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 133
- Issue
- 3
- Pages
- 790-796
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2096270055
- Cited by
- 829
- References
- 34
- Citations by year
- 2026: 67 · 2025: 70 · 2024: 68 · 2023: 69 · 2022: 81 · 2021: 78 · 2020: 85 · 2019: 96 · 2018: 72 · 2017: 64 · 2016: 37 · 2015: 27 · 2014: 13 · 2013: 1
- FWCI
- 23.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- penicillin allergy, drug hypersensitivity, Clostridium difficile infection, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, antibiotic exposure, length of hospital stay, hospitalized patients, fluoroquinolones, clindamycin, vancomycin, antibiotic stewardship
- MeSH terms
- Adult, Aged, Bacterial Infections, Delivery of Health Care, Drug Hypersensitivity, Female, Hospitalization, Humans, Length of Stay, Male, Middle Aged, Penicillins, Retrospective Studies, Cohort Studies, Prevalence, Health Care Costs
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
