We compared direct medical costs borne by the health care system and out-of-pocket costs borne by families for children with food allergy by socioeconomic characteristics. METHODS:We analyzed cross-sectional survey data collected between November 2011 and January 2012 from 1643 US caregivers with a food-allergic child. We used a 2-part regression model to estimate mean costs and identified differences by levels of household income and race or ethnicity. RESULTS:Children in the lowest income stratum incurred 2.5 times the amount of emergency department and hospitalization costs as a result of their food allergy than higher-income children ($1021, SE ±$209, vs $416, SE ±$94; P < .05). Costs incurred for specialist visits were lower in the lowest income group ($228, SE ±$21) compared with the highest income group ($311, SE ±$18; P < .01) as was spending on out-of-pocket medication costs ($117, SE ± $26, lowest income; $366, SE ±$44, highest income; P < .001). African American caregivers incurred the lowest amount of direct medical costs and spent the least on out-of-pocket costs, with average adjusted costs of $493 (SE ±$109) and $395 (SE ±$452), respectively.CONCLUSIONS: Disparities exist in the economic impact of food allergy based on socioeconomic status. Affordable access to specialty care, medications, and allergen-free foods are critical to keep all food-allergic children safe, regardless of income and race.

No abstract

RATIONALE: Penicillin (PCN) allergy is the most commonly reported medication allergy, self-reported by approximately 10% of the United States (US) population. Historically, 80-90% of patients with PCN allergy history were not allergic using penicillin skin testing (PST). Over the last 20 years, incidence of negative PST has increased to 95-98%. METHODS: A retrospective chart review at a 652-bed tertiary-care hospital from July 2011 to July 2014 was performed. Pre-PenÒ orders in the electronic medical record were the trigger for inclusion. PST results were recorded for each patient. RESULTS: 102 patients were referred, 88 were tested. 87 (98.9%) of patients had negative prick/puncture (PP) and intradermal testing (IDT). One had negative PP, but positive IDT. Fourteen were excluded; 6 refused testing, 1 was on antihistamines, 5 had no PST documentation, and 2 had no documented PCN allergy by history. CONCLUSIONS: Almost all patients with PCN allergy history are not PCN allergic and tolerate beta-lactams well. Consequently, using broadspectrum antibiotics that increase Vancomycin-Resistant Enterococci and Clostridium difficile infections, hospital length of stay and medical costs, in non-PST verified PCN allergy, is problematic. Less than 0.1% of 25 million individuals with PCN allergy history undergo PST in the US annually. The public health implications are compelling and PST should be performed before instituting alternative antibiotic therapy for PCN-sensitive infections. PST remains a sensitive and reliable test for true PCN allergy. Educating specialties outside of our field on PST will identify more individuals with inaccurate PCN allergy diagnoses, increase referrals, and play a critical role in antibiotic stewardship. Abstracts AB283MONDAY

No abstract