Feasibility, Benefits, and Limitations of a Penicillin Allergy Skin Testing Service.
OBJECTIVE
To critically examine the feasibility, benefits, and limitations of an inpatient penicillin skin testing service and how pharmacists can be utilized.


METHODS
A PubMed search was performed from July 2016 through September 2016 using the following search terms: penicillin skin testing, penicillin allergy, β-lactam allergy. Additional references were identified from a review of literature citations.


METHODS
All English-language studies assessing the use of penicillin skin testing as well as management and clinical outcomes of patients with a β-lactam allergy were evaluated.


RESULTS
The prevalence of people self-identifying as penicillin allergic ranges from 10% to 20% in the United States. Being improperly labeled as penicillin allergic is associated with higher health care costs, worse clinical outcomes, and an increased prevalence of multidrug-resistant infections. Penicillin skin testing can be a tool used to clarify penicillin allergies and has been demonstrated to be a successful addition to antimicrobial stewardship programs in multiple health care settings. Prior to implementing a penicillin skin testing service, institutions will need to perform a feasibility analysis of who will supply labor and accept the financial burden as well as identify if the positive benefits of a penicillin skin testing service overcome the limitations of this diagnostic test.


CONCLUSIONS
We conclude that institutions with high percentages of patients receiving non-β-lactams because of penicillin allergy labels would likely benefit the most from a penicillin skin testing service.
1 Mayo Clinic Hospital-Rochester, MN, USA.
Prasanna P
PP
Narayanan
2 University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
Meghan N
MN
Jeffres
D004342:Drug Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D007297:Inpatients; D010406:Penicillins / Q000009:adverse effects*; D010595:Pharmacists / Q000458:organization & administration; D015995:Prevalence; D012882:Skin Tests / Q000379:methods*; D047090:beta-Lactams / Q000009:adverse effects
D010406:Penicillins; D047090:beta-Lactams
allergy; anaphylaxis; infectious diseases; penicillins; β-lactams