{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:04:46Z","timestamp":1790881486563,"version":"4.1.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"unspecified","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X25000117_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>To explore the progress that the Veterans Health Administration has made to minimize the impact of the penicillin (PCN) allergy label, we determined the proportion of Veterans who reported a PCN-class allergy at the time of hospitalization and described antibiotic use in hospitalizations with and without a PCN-class allergy.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000117_as2\">\n\t    <jats:title>Design:<\/jats:title>\n\t    <jats:p>Cross-sectional study.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000117_as3\">\n\t    <jats:title>Participants:<\/jats:title>\n\t    <jats:p>National sample of 6,541,299 acute care admissions between 2011 and 2022.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000117_as4\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We calculated the prevalence of PCN-class allergies on admission and used Poisson regression to compare patterns of antibiotic use between hospitalizations with and without a PCN-class allergy.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000117_as5\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>The prevalence of PCN-class allergies on admission decreased from 12.99% to 11.20%. Use of cefazolin and non-pseudomonal third-generation cephalosporins increased regardless of PCN-class allergy status (\u201cPCN-class allergy only\u201d +11.46%, \u201cNo antibiotic allergy\u201d +4.92%). The prevalence ratio (PR) for antibiotic use in hospitalizations with a PCN-class allergy compared to hospitalizations without antibiotic allergies, decreased for anti-Methicillin Resistant <jats:italic>Staphylococcus aureus<\/jats:italic> agents (1.26 [1.25, 1.28] to 1.15 [1.13, 1.17]), carbapenems (1.59 [1.54, 1.65] to 1.47 [1.41, 1.53]), and aztreonam (23.89 [22.45, 25.43] to 17.57 [15.90, 19.42]); and increased for fluoroquinolones (1.58 [1.56, 1.60] to 2.15 [2.09, 2.20]).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X25000117_as6\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Prevalence of PCN-class allergies is declining and narrow-spectrum \u03b2L use is rising among hospitalized Veterans. Prescribing differences are decreasing between hospitalizations with and without a reported PCN-class allergy, except for aminoglycosides, clindamycin, and fluoroquinolones. These findings can serve to identify areas of focus for future analyses or interventions related to the impact of the PCN allergy label on antibiotic selection.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2025.11","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T03:44:30Z","timestamp":1740455070000},"source":"Crossref","is-referenced-by-count":1,"title":["Patterns of antimicrobial use among hospitalized Veterans with and without a penicillin-class allergy"],"prefix":"10.1017","volume":"5","author":[{"given":"Funnce","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Hoang-Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Ham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"McKenna C.","family":"Eastment","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6787-1140","authenticated-orcid":false,"given":"Luis G.","family":"Tulloch-Palomino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"key":"S2732494X25000117_ref12","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1136\/jclinpath-2014-202438","article-title":"A real-time prospective evaluation of clinical pharmaco-economic impact of diagnostic label of \u2018penicillin allergy\u2019 in a UK teaching hospital","volume":"67","author":"Li","year":"2014","journal-title":"J Clin Pathol"},{"key":"S2732494X25000117_ref26","unstructured":"26. Nguyen, PK , Pham, MT , Calub, F , Yusin, J and Graber, C. Penicillin De-Labeling in the Emergency Department. Veterans Health Administration. Presented at Antimicrobial Stewardship Taskforce Monthly Eduational Webinar on 20 May, 2022. Available via VHA intranet: https:\/\/dvagov.sharepoint.com\/sites\/VHAPBM\/ASTF\/SitePages\/ASP_Education.aspx. 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Allergy to Beta Lactam Evaluation (ABLE) Initiative. Clinical Pharmacy Practice Office, U.S. Department of Veterans Affairs. Available via VHA intranet: https:\/\/dvagov.sharepoint.com\/sites\/VHAClinicalPharmacy\/SitePages\/Allergy-to-Beta-Lactam-Evaluation-(ABLE).aspx. Accessed June 29, 2024."},{"key":"S2732494X25000117_ref8","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.jaci.2013.09.021","article-title":"Health care use and serious infection prevalence associated with penicillin \u201callergy\u201d in hospitalized patients: a cohort study","volume":"133","author":"Macy","year":"2014","journal-title":"J Allergy Clin Immunol"},{"key":"S2732494X25000117_ref36","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa475"},{"key":"S2732494X25000117_ref40","doi-asserted-by":"publisher","DOI":"10.1177\/0193945914566641"},{"key":"S2732494X25000117_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2021.12.258"},{"key":"S2732494X25000117_ref14","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1111\/all.13168","article-title":"Clinical outcomes following inpatient penicillin allergy testing: a systematic review and meta-analysis","volume":"72","author":"Sacco","year":"2017","journal-title":"Allergy"},{"key":"S2732494X25000117_ref1","unstructured":"1. McConeghy, KW , Caffrey, AR , Morrill, HJ , Trivedi, AN , LaPlante, KL . Are non-allergic drug reactions commonly documented as medication \u201callergies\u201d? A national cohort of Veterans\u2019 admissions from 2000 to 2014."},{"key":"S2732494X25000117_ref13","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jhin.2020.05.042","article-title":"Impact of penicillin allergy records on antibiotic costs and length of hospital stay: a single-centre observational retrospective cohort","volume":"106","author":"Powell","year":"2020","journal-title":"J Hosp Infect"},{"key":"S2732494X25000117_ref37","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.328"},{"key":"S2732494X25000117_ref6","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jhin.2021.04.011","article-title":"The impact of penicillin allergy de-labelling on the WHO AWaRe antibiotic categories: a retrospective cohort study","volume":"115","author":"Powell","year":"2021","journal-title":"J Hosp Infect"},{"key":"S2732494X25000117_ref35","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.12313"},{"key":"S2732494X25000117_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw118"},{"key":"S2732494X25000117_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2017.07.001"},{"key":"S2732494X25000117_ref29","unstructured":"29. About VHA. US Department of Veterans Affairs website. https:\/\/www.va.gov\/health\/aboutvha.asp. Accessed June 29, 2024."},{"key":"S2732494X25000117_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.08.027"},{"key":"S2732494X25000117_ref23","doi-asserted-by":"publisher","DOI":"10.3390\/pharmacy9030135"},{"key":"S2732494X25000117_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2009.01.034"},{"key":"S2732494X25000117_ref39","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2024.102"},{"key":"S2732494X25000117_ref31","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa475"},{"key":"S2732494X25000117_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw462"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X25000117","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T03:44:37Z","timestamp":1740455077000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X25000117\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"alternative-id":["S2732494X25000117"],"URL":"https:\/\/doi.org\/10.1017\/ash.2025.11","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e57"}}