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1. It is recommended that everyone with a Penicillin or Amoxicillin allergy get testing.

Choosing Wisely. American Academy of Allergy, Asthma & Immunology. Available from:

2. Higher prescription costs with Penicillin allergy

Mattingly II TJ, Fulton A, Lumish RA, Wiliams AMC, Yoon SJ, Yuen M, et al. The Cost of Self-Reported Penicillin Allergy: A Systematic Review. J Allergy Clin Immunol Pract 2018;6:1649-54

3. Higher healthcare costs with Penicillin allergy

Blumenthal KG, Li Y, Banerji A, Yun BJ, Long AA, Walensky RP. The Cost of Penicillin Allergy Evaluation. J Allergy Clin Immunol Pract. 2018;6(3): 1019-1027


Chen JR, Tarver SA, Alvarez KS, Wei W, Khan DA. Improving aztreonam stewardship and cost through a pencillin allergy testing clinical guideline. Open Forum Infect Dis. 2018. May 5;5(6)

4. Longer stays in hospital with Penicillin allergy


Jones BM, Bland CM. Penicillin skin testing as an antimicrobial stewardship initiative. Am J Health-Syst Pharm. 2017;74:232-7

5. Higher chance of C.Difficile diarrhea and MRSA infections with Penicillin allergy

Blumental KG, Lu N, Zhang Y, et al. Risk of methicillin resistant Staphyloccocus aureus, and Clostridium difficile in patients with a documented penicillin allergy: population based matched cohort study. BMJ 2018;361:k2400

6. More use of broad-spectrum antibiotics such as vancomycin with Penicillin allergy

Jones BM, Bland CM. Penicillin skin testing as an antimicrobial stewardship initiative. Am J Health-Syst Pharm. 2017;74:232-7

7. Higher chance of wound infection after surgery with Penicillin allergy

Blumental KG, Ryan EE, Yu L, Lee H, Kuhlen Jr. JL, Shenoy ES. The impact of a Reported Penicillin Allergy on Surgical Site Infection Risk. Clin Infect Dis. 2018 Jan 18;66(3):329-336

8. Higher chance of infection after joint replacement surgery with Penicillin allergy

Ponce B, Raines BT, Reed RD, Vick C, Richman J, Hawn M. Surgical site infection After Arthroplasty: Comparative effectiveness of prophylactic antibiotics. J Bone Joint Surg Am. 2014;96:970-7

Tan TL, Springer BD, Ruder JA, Ruffolo MR, Chen AF. Is Vancomycin-only prophylaxis for patients with penicillin allergy associated with increased risk of infection after arthroplasty? Clin Orthop Relat Res. 2016. July;474(7):1601-6


Yian EH, Chan PH, Burfeind W, Navarro RA, Singh A, Dillon MT. Perioperative Clindamycin Use in Penicillin Allergic Patients Is Associated With a Higher Risk of Infection After Shoulder Arthroplasty. J Am Acad Orthop Surg. 2019. July 11

9. Higher chance of Cesaerean section and longer stay in hospital after delivery with Penicillin allergy

Desai SH, Kaplan MS, Chen Q, Macy EM. Morbidity in Pregnant Women Associated with unverified penicillin allergies, antibiotic use, and Group B Streptococcus infections. Perm J 2017;21:16-080

10. In those people with proven penicillin allergy, less than 50% are still allergic to Penicillin after 5 years and less than 20% of people are still allergic to Penicillin after 10 years

Joint Task Force on Practice Parameters representing the American Academy of Allergy AaIACoA, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol.2010;105:259-73

11. More than 95% of people can safely receive Penicillin after appropriate allergy testing

Castells M, Khan DA, Phillips EJ. Penicillin Allergy. N Engl J Med. 2019; 381: 2338-51

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