Rj. Warrington et al., The value of skin testing for penicillin allergy in an inpatient population: Analysis of the subsequent patient management, ALL ASTH P, 21(5), 2000, pp. 297-299
It was decided to assess the value of skin testing in a group of inpatients
with a remote history of penicillin allergy, in terms of whether or not be
ta-lactams were subsequently given, if any adverse reactions occurred as a
result of this therapy, and if labeling of the patient record was changed s
ubsequent to skin testing and/or challenge. All patients seen in consultati
on with a history of penicillin allergy were assessed. When done, skin test
s were per formed with the major and minor determinants of penicillin and s
emisynthetic penicillins. Charts were reviewed after discharge in terms of
the antibiotics given during admission, adverse events, and the medical rec
ord and hospital database labeling for drug allergy at discharge. Skin test
ing was carried out in 79% of 67 patients assessed and in all, the tests we
re negative. Beta-lactam therapy was recommended in 51/53 patients but was
given in only 57% of these cases. At discharge, 49% of patients' records st
ill carried the penicillin allergy label, despite negative skin testing and
/or successful completion of a course of beta-lactam therapy. So, in approx
imately half of the patients reviewed, beta-lactams were not given despite
negative skin tests and a recommendation to do so, if indicated, and 49% of
patients were still inappropriately labeled as being penicillin-allergic o
n discharge.