Evaluating Clinical Outcomes of Penicillin Skin Testing in Affecting Inpatient Antibiotic Stewardship

Clinical outcomes following inpatient penicillin allergy testing: A systematic review and meta‐analysis

“…Two studies reported an annual healthcare saving, three studies found a cost saving per individual patient, while two studies were unable to report a statistically significant cost benefit (Table , Figure ).…”

“…Two studies were case-cohort studies, while the other 22 studies were cohort studies. 10,11,15,22,23,25,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] The included studies were grouped according to their inpatient population, inpatient intervention, and clinical outcomes described ( Figure 2). Table S1 summarizes the study characteristics, sample size, and study design.…”

“…Studies consistently reported change to a narrower spectrum antibiotic, switching to BLAs, and subsequently increased prescription of penicillin and cephalosporins. Two studies reported an annual healthcare saving, 22,37 three studies found a cost saving per individual patient, 11,23,42 while two studies were unable to report a statistically significant cost benefit 31,35 (Table S1, Figure 2).…”

“…We identified 24 studies, 17 full‐text articles, and seven conference abstracts. Two studies were case‐cohort studies, while the other 22 studies were cohort studies . The included studies were grouped according to their inpatient population, inpatient intervention, and clinical outcomes described (Figure ).…”

“…However, this may not be necessarily so given that broad‐spectrum antibiotics may be prescribed during subsequent admissions particularly in patients who had a negative inpatient PST but did not have their penicillin allergy removed from their medical record. Three studies reported 22.23%, 49%, and 92% of patients having the allergy still listed on the chart following a negative test. The magnitude of this lamentable statistic may be underestimated given that it may have been overlooked as a significant clinical outcome.…”