title: The economic burden of antibiotic treatment of penicillin-allergic patients in internal medicine wards of a general tertiary care hospital.
abstract: BACKGROUND
  Penicillin allergy poses a major problem in the management of infectious diseases.
  
  
  OBJECTIVE
  We estimated the costs and usage of antibiotic treatment of 'penicillin-allergic' patients in comparison to non-allergic patients in a tertiary care hospital.
  
  
  METHODS
  The study was based on the records of 118 randomly chosen in-hospital patients labelled as being 'allergic to penicillin' and who were treated with antibiotics. The antibiotic selection and cost of the patients with alleged penicillin allergy were compared to 118 matched patients without an antibiotic allergy (controls).
  
  
  RESULTS
  During in-hospital treatment, the mean antibiotic cost for penicillin-allergic patients was 63% higher than the cost for the controls. In addition, there was a 38% higher cost of the recommended anti-microbial treatment regimen to be followed upon discharge by the former compared to the latter.
  
  
  CONCLUSIONS
  Penicillin-allergic patients were more likely to receive broader spectrum antibiotics compared to the non-allergic ones. Since many of the patients who are labelled as being 'allergic to penicillin' are, in fact, not allergic to it, inaccurate reporting of penicillin allergies may have costly economic and epidemiologic repercussions in addition to more toxic effects which can occur when choosing alternative drugs in case of penicillin allergy.
authors.affiliation: Department of Medicine'T', Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. allergy@tasmc.health.gov.il
authors.forename: K
authors.initials: K
authors.lastname: Sade
authors.forename: I
authors.initials: I
authors.lastname: Holtzer
authors.forename: Y
authors.initials: Y
authors.lastname: Levo
authors.forename: S
authors.initials: S
authors.lastname: Kivity
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D016009:Chi-Square Distribution; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000191:economics*; D005260:Female; D006801:Humans; D008297:Male; D010406:Penicillins; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins