{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T02:05:14Z","timestamp":1774490714657,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,4,3]],"date-time":"2013-04-03T00:00:00Z","timestamp":1364947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Penicillin skin testing (PST) is a simple and reliable way of diagnosing penicillin allergy. After being off the market for 4 years, penicilloyl\u2010polylysine was reintroduced in 2009 as PRE\u2010PEN. We describe the negative predictive value (NPV) of PST and the impact on antibiotic selection in a sample of hospitalized patients with a reported history of penicillin allergy.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We introduced a quality improvement process at our 861\u2010bed tertiary care hospital that used PST to guide antibiotic usage in patients with a history consistent with an immunoglobulin E (IgE)\u2010mediated reaction to penicillin. Subjects with a negative PST were then transitioned to a \u03b2\u2010lactam agent for the remainder of their therapy. NPV of skin testing was established at 24\u2010hour follow\u2010up. We are reporting the result of 146 patients tested between March 2012 and July 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 146 patients with a history of penicillin allergy and negative PST were treated with \u03b2\u2010lactam antibiotics. Of these, only 1 subject experienced an allergic reaction to the PST. The remaining 145 patients tolerated a full course of \u03b2\u2010lactam therapy without an allergic response, giving the PST a 100% NPV. We estimated that PST\u2010guided antibiotic alteration for these patients resulted in an estimated annual savings of $82,000.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Patients with a history of penicillin allergy who have a negative PST result are at a low risk of developing an immediate\u2010type hypersensitivity reaction to \u03b2\u2010lactam antibiotics. The increased use of PST may help improve antibiotic stewardship in the hospital setting. <jats:italic>Journal of Hospital Medicine<\/jats:italic> 2013;8:341\u2013345. \u00a9 2013 Society of Hospital Medicine<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.2036","type":"journal-article","created":{"date-parts":[[2013,4,3]],"date-time":"2013-04-03T01:35:04Z","timestamp":1364952904000},"page":"341-345","source":"Crossref","is-referenced-by-count":130,"title":["The impact of penicillin skin testing on clinical practice and antimicrobial stewardship"],"prefix":"10.1002","volume":"8","author":[{"given":"Ramzy H.","family":"Rimawi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases Brody School of Medicine\u2013East Carolina University Greenville NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul P.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases Brody School of Medicine\u2013East Carolina University Greenville NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Gooch","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Vidant Medical Center Greenville NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Badih","family":"Kabchi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases Brody School of Medicine\u2013East Carolina University Greenville NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad S.","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases Brody School of Medicine\u2013East Carolina University Greenville NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bassam H.","family":"Rimawi","sequence":"additional","affiliation":[{"name":"Division of Reproductive Infectious Diseases Medical University of South Carolina Charleston SC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mulugeta","family":"Gebregziabher","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Medical University of South Carolina Charleston SC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawd S.","family":"Siraj","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases Brody School of Medicine\u2013East Carolina University Greenville NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,4,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60973-8"},{"key":"e_1_2_6_3_1","unstructured":"US Department of Veterans Affairs Web site.Benzypenicilloyl polylisine (PRE\u2010PEN) national drug monograph. May 2012. Available at:http:\/\/www.pbm.va.gov\/DrugMonograph.aspx. Accessed September 1 2012."},{"key":"e_1_2_6_4_1","doi-asserted-by":"crossref","unstructured":"ParkM JamesT.Diagnosis and management of penicillin allergy.Mayo Clin Proc.2005;80(3):405\u2013410.","DOI":"10.4065\/80.3.405"},{"key":"e_1_2_6_5_1","unstructured":"PRE\u2010PEN penicillin skin test antigen. Available at:http:\/\/www.alk\u2010abello.com\/us\/products\/pre\u2010pen\/Pages\/PREPEN.aspx. Accessed September 1 2012."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2010.08.002"},{"key":"e_1_2_6_7_1","first-page":"51","article-title":"Immunochemical mechanisms in penicillin allergy","volume":"24","author":"Parker CW","year":"1965","journal-title":"Fed Proc."},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2007.02867.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1201\/9780203911341"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","unstructured":"RichterAG WongG GoddardS et al.Retrospective case series analysis of penicillin allergy testing in a UK specialist regional allergy clinic.J Clin Pathol.2011;64:1014\u20131018.","DOI":"10.1136\/jcp.2010.088203"},{"issue":"1","key":"e_1_2_6_11_1","first-page":"59","article-title":"Prevalence of skin test reactivity in patients with convincing, vague and unnacceptible histories of penicillin allergy","volume":"26","author":"Stember RH","year":"2005","journal-title":"Allergy Asthma Proc."},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62546-X"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.18.2819"}],"container-title":["Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjhm.2036","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhm.2036","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jhm.2036","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhm.2036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T15:31:01Z","timestamp":1760628661000},"score":1,"resource":{"primary":{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/10.1002\/jhm.2036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,3]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2013,6]]}},"alternative-id":["10.1002\/jhm.2036"],"URL":"https:\/\/doi.org\/10.1002\/jhm.2036","archive":["Portico"],"relation":{},"ISSN":["1553-5592","1553-5606"],"issn-type":[{"value":"1553-5592","type":"print"},{"value":"1553-5606","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,4,3]]}}}