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

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Choosing Wisely. American Academy of Allergy, Asthma & Immunology. Available from: https://www.choosingwisely.org/clinician-lists/american-academy-allergy-asthma-immunlogy-non-beta-lactam-antibiotics-penicillin-allergy/

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2. Higher prescription costs with Penicillin allergy

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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

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3. Higher healthcare costs with Penicillin allergy

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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)

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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

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

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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

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

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

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

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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

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

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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

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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

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

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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

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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

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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

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

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