title: Clinical outcomes of penicillin skin testing.
abstract: BACKGROUND
  Penicillin or cephalosporin allergy is a common problem with antibiotic drug prescribing in hospitalized patients.
  
  
  OBJECTIVE
  To study the various clinical outcomes of penicillin skin testing (PST) in a community teaching hospital and to determine the percentage of patients who have an antibiotic drug modification after PST.
  
  
  METHODS
  This study was a retrospective medical record review of all inpatients who underwent PST in 6.6 years. Information was collected on 101 patients using a detailed data collection form. Data were summarized using descriptive statistics, including frequencies and percentages.
  
  
  RESULTS
  Of the 101 patients who underwent PST, 92 had a negative result and 5 had a positive result; in 4 patients the test result was indeterminate. There was a 96% (67/70) reduction in the use of vancomycin and a 96% (23/24) reduction in the use of fluoroquinolones after PST in patients with negative results. Forty-nine percent of patients with negative PST results were administered a penicillin-based drug, and 48% were given a cephalosporin. Cultures were positive most commonly for Staphylococcus aureus and enterococcus. There were no serious adverse reactions to PST or to the use of penicillins or cephalosporins after a negative PST result.
  
  
  CONCLUSIONS
  Penicillin skin testing lowered the use of vancomycin and fluoroquinolones and increased the use of penicillin-based drugs and cephalosporins in patients with a history of beta-lactam drug allergies.
authors.affiliation: Department of Internal Medicine, Allergy and Immunology, Abington Memorial Hospital, Abington, Pennsylvania 19001, USA. knadarajah@fhcs.org
authors.forename: Kamalini
authors.initials: K
authors.lastname: Nadarajah
authors.forename: George R
authors.initials: GR
authors.lastname: Green
authors.forename: Mary
authors.initials: M
authors.lastname: Naglak
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002511:Cephalosporins / Q000009:adverse effects / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D024841:Fluoroquinolones / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D010406:Penicillins / Q000009:adverse effects* / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012882:Skin Tests / Q000706:statistics & numerical data*; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D024841:Fluoroquinolones; D010406:Penicillins; D014640:Vancomycin