{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:48:51Z","timestamp":1790214531933,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antibiotic allergy de\u2010labeling using penicillin allergy skin testing (PAST) can reduce the use and cost of alternative, non\u2010\u03b2\u2010lactam antibiotics in general inpatient populations. This strategy's role in hematopoietic stem cell transplant (HSCT) recipients is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study aimed to determine the effect of a pre\u2010transplant PAST protocol on antibiotic use, days of therapy (DOT), and cost in an immunocompromised population at a single center from 7\/1\/2010\u20102\/1\/2019. Patients who received chimeric antigen receptor (CAR) T\u2010cell therapy and those who underwent transplantation in the outpatient setting were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1560 patients who underwent inpatient HSCT during the study period, 208 reported \u03b2\u2010lactam allergy (136\/844 [16%] pre\u2010 and 72\/716 [10%] post\u2010implementation; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). PAST was performed on 7% and 54% of HSCT recipients pre\u2010 and post\u2010implementation, respectively. Only two positive PAST were noted. There were no adverse reactions to PAST. There were no significant differences in the disease and transplant characteristics between the two groups. Days of therapy and cost of alternative antibiotics significantly decreased post\u2010implementation (mean 788 vs 627\u00a0days, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01; mean $24\u00a0425 vs $17\u00a0518, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.009).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Penicillin allergy skin testing adjudicates reported \u03b2\u2010lactam allergy in HSCT recipients, lowering use, DOT, and cost of alternative antibiotics and promoting effective formulary agents to treat immunocompromised HSCT recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13175","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T17:37:55Z","timestamp":1569001075000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Penicillin allergy skin testing as an antibiotic stewardship intervention reduces alternative antibiotic exposures in hematopoietic stem cell transplant recipients"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1252-734X","authenticated-orcid":false,"given":"Anita R.","family":"Modi","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Respiratory Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7082-891X","authenticated-orcid":false,"given":"Navneet S.","family":"Majhail","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Taussig Cancer Institute Cleveland Clinic Cleveland OH USA"},{"name":"Transplantation Center Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Rybicki","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic Cleveland OH 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