Date of Award

5-2020

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Julie Solberg

Keywords

Penicillin Allergy; β-lactam Allergy; Allergy Testing; Penicillin; Penicillin Testing; Penicillin Cost; and Penicillin Allergy Risks

Abstract

The purpose of this review is to investigate the prevalence of documented penicillin (PCN) allergies in health care and any negative outcomes associated with being labeled as such. Additional topics researched included the safety and accuracy of PCN allergy testing, the cost-effectiveness of PCN allergy testing versus using non-PCN related antibiotics, and barriers to confirmatory PCN allergy testing implementation. A complete review of the aforementioned topics included meta-analysis’, systematic reviews, cohorts, clinical trials, and cross-sectional studies from the last five years. Databases utilized for this research included PubMed, Cochrane Review, Embase, Dynamed Plus, and ClinicalKey. Sources that were excluded from this review included opinion-based editorials and those that failed to include analytical review of scientific research. A total of 18 scholarly sources were utilized for this review. The research revealed a significant portion of the population is incorrectly labeled as having a PCN allergy when properly tested. It also showed that having a PCN allergy is associated with increased morbidity and mortality. Research related to PCN allergy testing indicated high levels of safety and accuracy. Also, PCN allergy testing costs were found to be significantly lower than those associated with using alternative antibiotics. Lastly, a majority of the barriers related to performing PCN allergy testing were largely due to a lack of education on behalf of medical providers and incorrect perceptions from both patients and medical providers alike. These findings together indicate that confirmatory PCN allergy testing in the outpatient setting is safe, accurate, and cost-effective in decreasing the morbidity and mortality associated with having an incorrect PCN allergy label. However, further research is needed to adequately address the barriers and incorrect perceptions both providers and patients possess related to PCN allergy testing.

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