M Li1, M T Krishna2, S Razaq3, D Pillay1. 1. Department of Microbiology, Birmingham Heartlands Hospital, Birmingham, UK. 2. Department of Allergy and Immunology, Birmingham Heartlands Hospital, Birmingham, UK University of Warwick and University of Birmingham, Birmingham, UK. 3. Pharmacy Department, Birmingham Heartlands Hospital, Birmingham, UK.
Abstract
AIMS: To perform a pharmaco-economic analysis of prescribing alternative antibiotics in patients with a diagnostic label of 'penicillin allergy' and assess whether collation of information from a structured history and liaison with the family physician could reduce costs. METHODS: A prospective pro-forma-based interview of randomly selected in-patients and their family physician was used to assess the validity of the diagnostic label of 'penicillin allergy'. Cost analysis of prescription of alternative antibiotics was performed and compared with first-line agents. RESULTS: 102 patients were assessed and only 40% (n=41) were found to have a history consistent with penicillin hypersensitivity, 40% (n=41) were likely 'not allergic' and 20% (n=20) had 'indeterminate' reactions. Total cost of antibiotics prescribed for patients with penicillin allergy was 1.82-2.58-fold higher than for first-line antibiotics. CONCLUSIONS: Obtaining a structured history from the patient and family physician alone can enable an accurate identification of penicillin allergy status. Total acquisition cost of second-line antibiotics is higher than if these patients were prescribed first-line antibiotics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
AIMS: To perform a pharmaco-economic analysis of prescribing alternative antibiotics in patients with a diagnostic label of 'penicillinallergy' and assess whether collation of information from a structured history and liaison with the family physician could reduce costs. METHODS: A prospective pro-forma-based interview of randomly selected in-patients and their family physician was used to assess the validity of the diagnostic label of 'penicillinallergy'. Cost analysis of prescription of alternative antibiotics was performed and compared with first-line agents. RESULTS: 102 patients were assessed and only 40% (n=41) were found to have a history consistent with penicillinhypersensitivity, 40% (n=41) were likely 'not allergic' and 20% (n=20) had 'indeterminate' reactions. Total cost of antibiotics prescribed for patients with penicillinallergy was 1.82-2.58-fold higher than for first-line antibiotics. CONCLUSIONS: Obtaining a structured history from the patient and family physician alone can enable an accurate identification of penicillinallergy status. Total acquisition cost of second-line antibiotics is higher than if these patients were prescribed first-line antibiotics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Jason A Trubiano; Cosby A Stone; M Lindsay Grayson; Karen Urbancic; Monica A Slavin; Karin A Thursky; Elizabeth J Phillips Journal: J Allergy Clin Immunol Pract Date: 2017-08-23
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Authors: Cosby A Stone; Jason Trubiano; David T Coleman; Christine R F Rukasin; Elizabeth J Phillips Journal: Allergy Date: 2019-05-26 Impact factor: 13.146