ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Penicillin Allergy Testing Is Cost-Saving: An Economic Evaluation Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- The cost-effectiveness of penicillin allergy testing: Evidence and gaps from a systematic review.PloS one · 2025Pooled it
- Penicillin Allergy Testing and Delabeling for Patients Who Are Prescribed Penicillin: A Systematic Review for a World Health Organization Guideline.Clinical reviews in allergy & immunology · 2024Pooled it
- Strategies to Increase Equitable Access to Penicillin Allergy Delabeling Interactions: A Qualitative Study.JAMA network open · 2026Article
- Society for Maternal-Fetal Medicine Special Statement: Assessment and management of reported penicillin allergy in pregnancy.Pregnancy (Hoboken, N.J.) · 2026Article
- Penicillin Allergy, Really?-A Cross-Sectional Mixed-Methods Study in Baden-Württemberg, Germany, to Explore General Practitioner Perspectives on Delabeling Potential in Primary Care.Antibiotics (Basel, Switzerland) · 2026Article
- Impact of a Pharmacist-Driven Penicillin Allergy De-Labeling Service (PADLS) on Hospitalized Patients.Pharmacy (Basel, Switzerland) · 2026Article
- Antimicrobial and diagnostic stewardship: opportunities for return on investment.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Discrepancies in Beta-Lactam Antibiotics Cross-Reactivity: Implications for Clinical Practice.Allergy · 2025Article
- Using the Electronic Health Record to Facilitate Drug Allergy Delabeling.Current allergy and asthma reports · 2025Review
- Resensitization-Should Repeat Testing Be Performed in Patients Undergoing Penicillin Allergy Evaluations? A Pro-Con Debate.The journal of allergy and clinical immunology. In practice · 2025Review
- An Economic Evaluation of Direct Oral Penicillin Challenge for De-Labelling Low Risk Patients With a Penicillin Allergy Label.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2025Article
- Drug allergy.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2025Review
- Review
- Patterns of antimicrobial use among hospitalized Veterans with and without a penicillin-class allergy.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Delabeling of allergy to beta-lactam antibiotics in hospitalized patients: a prospective study evaluating cost savings.International journal of clinical pharmacy · 2024Article
- Penicillin allergy delabeling has a significant impact on subsequent antibiotic use in primary care.The World Allergy Organization journal · 2024Article
- Impact of penicillin allergy labels on surgical site infections in a large UK cohort of gastrointestinal surgery patients.JAC-antimicrobial resistance · 2024Article
- Resource utilization and cost assessment of a proactive penicillin allergy de-labeling program for low-risk inpatients.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2024Article
- Delabeling, safety, and impact of β-lactam allergy testing: A systematic review.The journal of allergy and clinical immunology. Global · 2023Article
- Assessment of Need for Improved Identification of a Culprit Drug in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.JAMA dermatology · 2023Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundHaving a penicillin allergy label is associated with the use of less appropriate and more expensive antibiotics and increased healthcare utilization. Penicillin allergy testing results in delabeling most allergy claimants and may be cost-saving. This study aimed to project whether penicillin allergy testing in patients reporting a penicillin allergy is cost-saving.
methodsIn this economic evaluation study, we built decision models to project the economic impact of 2 strategies for a patient with a penicillin allergy label: (1) perform diagnostic testing (drug challenges, with or without skin tests); and (2) do not perform diagnostic testing. The health service perspective was adopted, considering costs with penicillin allergy tests, and with hospital bed-days/outpatient visits, antibiotic use, and diagnostic testing. Twenty-four base case decision models were built, accounting for differences in the diagnostic workup, setting (inpatient vs outpatient) and geographic region. Uncertainty was explored via probabilistic sensitivity analyses.
resultsPenicillin allergy testing was cost-saving in all decision models built. For models assessing the performance of both skin tests and drug challenges, allergy testing resulted in average savings (in United States [US] dollars) of $657 for inpatients (US: $1444; Europe: $489) and $2746 for outpatients (US: $256; Europe: $6045). 75% of simulations obtained through probabilistic sensitivity analysis identified testing as the less costly option.
conclusionsPenicillin allergy testing was projected to be cost-saving across different scenarios. These results are devised to inform guidelines, supporting the adoption of policies promoting widespread testing of patients with a penicillin allergy label.
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What OpenQuestion holds
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.