Abstract
Introduction Following penicillin skin testing and oral challenge, up to 90% of individuals reporting a PCN allergy are not found to be allergic. Patients with a PCN “allergy” are exposed to more and broader antibiotics, increasing their risk of developing antibiotic-associated and antibiotic-resistant infections. In this study, we compare the prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile infections among patients with a reported PCN allergy to that of PCN non-allergic patients. Methods In this retrospective study, PCN-allergic and control cohorts were created using the EPIC electronic medical record (EMR) database to investigate patients admitted to a university hospital between 2014-2017. Discharge diagnoses were extracted by ICD-10 codes. The primary outcome included infections with C. difficile and MRSA. The secondary outcome was hospital length of stay (LOS). We compared the two groups controlling for differences through a set of confounders. Results The rate of MRSA infection was significantly increased among PCN-allergic patients compared to PCN non-allergic patients (0.69% vs 0.21%, pC. difficile infection was increased among PCN-allergic patients compared to controls, but only among males (14% vs 2%, p Conclusions A diagnosis of penicillin “allergy” increases one's likelihood of developing antibiotic-resistant infections. One limitation is that data extraction relies on diagnosis codes entered into the EMR, which is largely provider-dependent. This research suggests that verifying PCN allergy can improve antibiotic stewardship and patient outcomes.
Published Version
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