{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T16:12:31Z","timestamp":1788797551835,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rhinosinusitis (RS) is prevalent in the ambulatory setting. When indicated, treatment with penicillin is recommended. However, up to 25% of the US population has a penicillin allergy label (PAL) within their health record, which can result in treatment with second\u2010line antibiotics. The study explored the effect of PAL on clinical outcomes in RS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective chart review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Ochsner Medical Centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A chart review was performed in adult patients with RS who received antibiotics between 2011 and 2024. Treatment failure was defined as need for a second antibiotic within 30 days. Adverse events (AE) were indexed to a new diagnosis of diarrhea within 30 days. Odds ratio (OR) of success:AE was calculated and compared to standard of care, using Cohen's\n                      <jats:italic>h<\/jats:italic>\n                      to measure the effect size of nonpenicillin antibiotics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      335,015 subjects who received antibiotics for RS were included. Of these, 55,557 (16.6%) had PAL. These patients were more likely to receive a nonpenicillin antibiotic for initial therapy (87.8%). Patients with a PAL had a slightly greater rate of treatment success (78.2% vs 75.8%,\n                      <jats:italic>h<\/jats:italic>\n                      \u2009=\u20090.057), but a greater AE rate (1.8% vs 1.7%,\n                      <jats:italic>h<\/jats:italic>\n                      \u20100.015). Among second\u2010line treatments for patients with PAL, tetracycline had a superior OR of success: AE (0.983, 95% CI 0.906\u20100.894) compared to fluoroquinolones (0.842, 95% CI 0.843\u20100.831).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with RS, PAL often leads to the prescription of a second\u2010line antibiotic, which has decreased benefit\u2010to\u2010risk ratio compared to first\u2010line treatment. This emphasizes the need for additional efforts to remove PALs from patients without true penicillin allergy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70209","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T12:54:34Z","timestamp":1774443274000},"page":"1442-1449","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Penicillin Allergy Label on Antibiotic Treatment Outcomes in Adult Patients with Rhinosinusitis"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8744-9171","authenticated-orcid":false,"given":"Dylan A.","family":"Levy","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Tulane University School of Medicine"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Ochsner Clinic Foundation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duncan G. 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