{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:59:01Z","timestamp":1780531141715,"version":"3.54.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,11,2]],"date-time":"2019-11-02T00:00:00Z","timestamp":1572652800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Results of a study evaluating the implementation and impact of a pharmacist-driven penicillin skin testing (PST) service for patients prescribed alternative antibiotics in the community hospital setting are reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective pilot service in which patients with a documented penicillin allergy (type I, immunoglobulin E [IgE]\u2013mediated) and were prescribed alternative antibiotics received PST by a trained pharmacist was implemented; if test results were negative, the allergy was de-labeled from their electronic medical record. The primary objective was the percentage of patients switched to first-line antibiotics. Secondary objectives included length of stay (LOS) and inpatient antimicrobial costs to the health system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-two patients were proactively identified and received PST by a pharmacist. Of those tested, all were negative, with no type I (IgE-mediated) hypersensitivity reactions to the test itself or to the beta-lactam antibiotic administered thereafter; 68.2% (15\/22) were successfully transitioned to a beta-lactam after PST. As a result, a decrease in the use of fluoroquinolones and vancomycin and an increase in use of narrow penicillin-based antibiotics and first- and second-generation cephalosporins were observed. The mean \u00b1 S.D. LOS per patient was 7.41 \u00b1 6.1 days, and the total cost of inpatient antimicrobial therapy to the health system was $1,698.88.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A pharmacist-driven PST service was successfully implemented in a community hospital setting.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ajhp\/zxz237","type":"journal-article","created":{"date-parts":[[2019,11,2]],"date-time":"2019-11-02T09:29:47Z","timestamp":1572686987000},"source":"Crossref","is-referenced-by-count":5,"title":["Pharmacist-driven penicillin skin testing service for adults prescribed nonpreferred antibiotics in a community hospital"],"prefix":"10.1093","author":[{"given":"Ethan","family":"Englert","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Paoli Hospital \u2013 Main Line Health, Paoli, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Weeks","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Department of Medicine, Infectious Disease, Paoli Hospital \u2013 Main Line Health, Paoli, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,31]]},"reference":[{"key":"2019110205293479100_CIT0001","doi-asserted-by":"crossref","first-page":"489","DOI":"10.2500\/aap.2014.35.3791","article-title":"Prevalence and characteristics of reported penicillin allergy in an urban outpatient adult population","volume":"35","author":"Albin","year":"2014","journal-title":"Allergy Asthma Proc."},{"key":"2019110205293479100_CIT0002","first-page":"540","article-title":"Using \u03b2-lactam antibiotics in patients with a history of \u03b2-lactam allergy: current concepts","volume":"127","author":"Moreno","year":"2017","journal-title":"Pol Arch Intern Med."},{"key":"2019110205293479100_CIT0003","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1592\/phco.31.8.742","article-title":"Impact of an antimicrobial allergy label in the medical record on clinical outcomes in hospitalized patients","volume":"31","author":"Charneski","year":"2011","journal-title":"Pharmacotherapy."},{"key":"2019110205293479100_CIT0004","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":"2019110205293479100_CIT0005","unstructured":"U.S. Food and Drug Administration. FDA drug safety communication: FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects (July 2016).http:\/\/www.fda.gov\/downloads\/Drugs\/DrugSafety\/UCM513019.pdf (accessed 2019 Jan 20)."},{"issue":"10","key":"2019110205293479100_CIT0006","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1093\/cid\/ciw118","article-title":"Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America","volume":"62","author":"Barlam","year":"2016","journal-title":"Clin Infect Dis."},{"key":"2019110205293479100_CIT0007","first-page":"S1","article-title":"Allergy diagnostic testing: an updated practice parameter","volume":"100","author":"Bernstein","year":"2008","journal-title":"Ann Allergy Asthma Immunol."},{"key":"2019110205293479100_CIT0008","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s13223-015-0098-5","article-title":"A retrospective comparison of false negative skin test rates in penicillin allergy, using pencilloyl-poly-lysine and minor determinants or penicillin G, followed by open challenge","volume":"11","author":"Rosenfield","year":"2015","journal-title":"Allergy Asthma Clin Immunol."},{"key":"2019110205293479100_CIT0009","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1002\/phar.1288","article-title":"Penicillin skin testing: potential implications for antimicrobial stewardship","volume":"33","author":"Unger","year":"2013","journal-title":"Pharmacotherapy."},{"issue":"1","key":"2019110205293479100_CIT0010","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4103\/2231-4040.70513","article-title":"The facts about penicillin allergy: a review","volume":"1","author":"Bhattacharya","year":"2010","journal-title":"J Adv Pharm Technol Res."},{"key":"2019110205293479100_CIT0011","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1186\/1710-1492-7-S1-S1","article-title":"An 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bronchoprovocation","volume":"115","author":"Marshik","year":"1999","journal-title":"Chest."},{"key":"2019110205293479100_CIT0017","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/S1081-1206(10)62539-2","article-title":"Risks of penicillin skin testing","volume":"85","author":"Macy","year":"2000","journal-title":"Ann Allergy Asthma Immunol."},{"key":"2019110205293479100_CIT0018","doi-asserted-by":"crossref","first-page":"232","DOI":"10.2146\/ajhp160233","article-title":"Penicillin skin testing as an antimicrobial stewardship initiative","volume":"74","author":"Jones","year":"2017","journal-title":"Am J Health-Syst Pharm."},{"key":"2019110205293479100_CIT0019","doi-asserted-by":"crossref","first-page":"ofz109","DOI":"10.1093\/ofid\/ofz109","article-title":"Clinical and economic outcomes of penicillin skin testing as an antimicrobial stewardship initiative in a community health system","volume":"6","author":"Jones","year":"2019","journal-title":"Open Forum Infect 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testing","volume":"42","author":"Gugkaeva","year":"2017","journal-title":"J Clin Pharm Ther."},{"key":"2019110205293479100_CIT0023","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."}],"container-title":["American Journal of Health-System 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