Clinical outcomes of penicillin skin testing.
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.
Nadarajah
Kamalini
K
Department of Internal Medicine, Allergy and Immunology, Abington Memorial Hospital, Abington, Pennsylvania 19001, USA. knadarajah@fhcs.org
Green
George R
GR
Naglak
Mary
M
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
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D024841:Fluoroquinolones; D010406:Penicillins; D014640:Vancomycin