ArticleThe Journal of allergy and clinical immunology2017
Tackling inpatient penicillin allergies: Assessing tools for antimicrobial stewardship.
Article in The Journal of allergy and clinical immunology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 4 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
70 citing papers in PubMed, 4 syntheses or guidelines pooled it, 144 citations in OpenAlex.
- [On the German S3 guideline on perioperative and periinterventional antibiotic prophylaxis].HNO · 2026Guideline
- Pooled it
- The Use of Electronic Health Records to Study Drug-Induced Hypersensitivity Reactions from 2000 to 2021: A Systematic Review.Immunology and allergy clinics of North America · 2022Pooled it
- Use of stewardship smartphone applications by physicians and prescribing of antimicrobials in hospitals: A systematic review.PloS one · 2020Pooled it
- De-Labeling of Penicillin Allergy in the Emergency Department at a Veterans Affairs Hospital.The western journal of emergency medicine · 2026Article
- Outcomes of a penicillin allergy de-labelling implementation intervention in a UK hospital: a prospective, single centre, type 2 hybrid effectiveness-implementation study evaluated using mixed methods.Implementation science communications · 2026Article
- Clinical Outcome Associated With Beta-Lactam Allergy Labels in Hospitalized Patients in Belgium.Clinical and translational allergy · 2026Article
- The Feasibility and Applicability of Pediatric Inpatient Beta Lactam De-Labeling: From Bedside Challenge to Long-Term Follow Up.Infection & chemotherapy · 2026Article
- Assessment of penicillin allergy evaluation practices among clinicians in China: a nationwide cross-sectional survey.BMJ open · 2025Article
- Using the Electronic Health Record to Facilitate Drug Allergy Delabeling.Current allergy and asthma reports · 2025Review
- Impact of integrating guidelines into an antimicrobial stewardship smartphone application on outpatient antibiotic prescribing: a segmented interrupted time series analysis.Frontiers in digital health · 2025Article
- Article
- Penicillin allergy delabeling in long-term care facilities: if not now, then when?Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Developing and disseminating an electronic penicillin allergy de-labelling tool using the model for improvement framework.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2024Article
- Implementation and outcomes of beta-lactam allergy management protocol at a comprehensive cancer center.Infection · 2024Article
- Examining Antimicrobial Stewardship Program Implementation in Carceral Settings.AMA journal of ethics · 2024Article
- How to Define and Manage Low-Risk Drug Allergy Labels.The journal of allergy and clinical immunology. In practice · 2024Review
- An urgent need for capacity building towards establishment of drug allergy management systems in the Indian sub-continent.The Lancet regional health. Southeast Asia · 2024Article
- Don't we overestimate drug allergies in children?International journal of occupational medicine and environmental health · 2023Article
- [Antibiotic allergies: targeted approach in suspected β‑lactam allergy].Urologie (Heidelberg, Germany) · 2023Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundReported penicillin allergy rarely reflects penicillin intolerance. Failure to address inpatient penicillin allergies results in more broad-spectrum antibiotic use, treatment failures, and adverse drug events.
objectiveWe aimed to determine the optimal approach to penicillin allergies among medical inpatients.
methodsWe evaluated internal medicine inpatients reporting penicillin allergy in 3 periods: (1) standard of care (SOC), (2) penicillin skin testing (ST), and (3) computerized guideline application with decision support (APP). The primary outcome was use of a penicillin or cephalosporin, comparing interventions to SOC using multivariable logistic regression.
resultsThere were 625 patients: SOC, 148; ST, 278; and APP, 199. Of 278 ST patients, 179 (64%) were skin test eligible; 43 (24%) received testing and none were allergic. In the APP period, there were 292 unique Web site views; 112 users (38%) completed clinical decision support. Although ST period patients did not have increased odds of penicillin or cephalosporin use overall (adjusted odds ratio [aOR] 1.3; 95% CI, 0.8-2.0), we observed significant increased odds of penicillin or cephalosporin use overall in the APP period (aOR, 1.8; 95% CI, 1.1-2.9) and in a per-protocol analysis of the skin tested subset (aOR, 5.7; 95% CI, 2.6-12.5).
conclusionsBoth APP and ST-when completed-increased the use of penicillin and cephalosporin antibiotics among inpatients reporting penicillin allergy. While the skin tested subset showed an almost 6-fold impact, the computerized guideline significantly increased penicillin or cephalosporin use overall nearly 2-fold and was readily implemented.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.