Impacts of risk-stratified inpatient penicillin allergy label delabeling on subsequent antimicrobial spectrum index and costs

Milner Staub; George E Nelson; Kelly Byrge; Grace Koo; Whitney J Nesbitt; Joanna L Stollings; Minhua Zhang; Cosby A Stone Jr

doi:10.1017/ash.2024.421

Impacts of risk-stratified inpatient penicillin allergy label delabeling on subsequent antimicrobial spectrum index and costs

Antimicrob Steward Healthc Epidemiol. 2024 Oct 3;4(1):e160. doi: 10.1017/ash.2024.421. eCollection 2024.

Authors

Milner Staub^{1

2}, George E Nelson¹, Kelly Byrge¹, Grace Koo³, Whitney J Nesbitt⁴, Joanna L Stollings⁴, Minhua Zhang⁵, Cosby A Stone Jr³

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
² Medicine Service Line, Infectious Diseases Section, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA.
³ Division of Allergy and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
⁴ Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN, USA.
⁵ Quality, Safety, and Risk Prevention, Vanderbilt University Medical Center, Nashville, TN, USA.

Abstract

Penicillin allergy delabeling may benefit antimicrobial stewardship (AS). Cost of initial penicillin treatments following risk-stratified inpatient delabeling were compared to two hypothetical treatment regimens if delabeling had not occurred: (1) AS-guided and (2) Common Treatment. Penicillin allergy delabeling improved antimicrobial spectrum index, was cost-neutral, and averted unnecessary penicillin desensitizations.