{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:26:54Z","timestamp":1789586814074,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,11,5]],"date-time":"2017-11-05T00:00:00Z","timestamp":1509840000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The majority of patients with penicillin allergy labels tolerate penicillins. Inappropriate avoidance of penicillin is associated with increased hospitalisation, infections and healthcare costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To examine the documentation of penicillin adverse drug reactions (<jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content>) in a large\u2010scale hospital\u2010based electronic health record.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Penicillin <jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content> were extracted from 96\u2009708 patient records in the Enterprise Patient Administration System in South Australia. Expert criteria were used to determine consistency of <jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content> entry and suitability for further evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 43\u2009011 unique <jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content> reports, there were 5023 <jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content> to penicillins with most being entered as allergy (<jats:italic>n<\/jats:italic>\u2009=\u20094773, 95.0%) rather than intolerance (<jats:italic>n<\/jats:italic>\u2009=\u2009250, 5.0%). A significant proportion did not include a reaction description (<jats:italic>n<\/jats:italic>\u2009=\u20091052, 20.9%). Using pre\u2010set criteria, 10.1% of reports entered as allergy had a reaction description that was consistent with intolerance and 31.0% of the entered intolerances had descriptions consistent with allergy. Virtually all <jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u2009=\u20094979, 99.1%) were appropriate for further evaluation by history taking or immunological testing and half (50.7%, <jats:italic>n<\/jats:italic>\u2009=\u20092549) had documented reactions suggesting low\u2010risk of penicillin allergy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The frequency of penicillin allergy label in this data set is consistent with the known overdiagnosis of penicillin allergy in the hospital population. <jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content> documentation was poor with incomplete entries and inconsistent categorisation. The concepts of allergy and intolerance for <jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content> classification, whilst mechanistically valid, may not be useful at the point of <jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content> entry by generalist clinicians. Systematic evaluation of reported <jats:styled-content style=\"fixed-case\">ADR<\/jats:styled-content> is needed to improve the quality of information for future prescribers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13558","type":"journal-article","created":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T14:56:40Z","timestamp":1500994600000},"page":"1292-1297","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Documentation of penicillin adverse drug reactions in electronic health records: inconsistent use of allergy and intolerance labels"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0486-9013","authenticated-orcid":false,"given":"Joshua M.","family":"Inglis","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian 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