{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T12:31:51Z","timestamp":1793881911902,"version":"4.7.0"},"reference-count":27,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,2,3]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine outcomes in hospitalised patients with sepsis and reported penicillin allergy (PcnA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational retrospective cohort study using data from electronic health records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A large single health system with 11 hospitals of small, medium and large sizes including a 630-bed tertiary care teaching hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients (n=5238) \u226518 years of age, hospitalised with sepsis, severe sepsis or septic shock between 1 January 2016 and 31 December 2018, received antibacterial agents, and had documented PcnA status. Patients &lt;18 years of age at admission were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>\n                      Primary outcomes evaluated were inpatient mortality and 30-day mortality posthospital discharge. Secondary outcomes were hospital length of stay, 30-day readmissions, duration of antibiotic use, rate of\n                      <jats:italic>Clostridium difficile<\/jats:italic>\n                      infection and total cost of care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was no difference in outcomes including inpatient or 30-day mortality, hospital length of stay, in-hospital antibiotic duration,\n                      <jats:italic>C. difficile<\/jats:italic>\n                      infection, total cost of care and 30-day readmission rate between patients labelled with a PcnA vs patients who did not report PcnA (non-PcnA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this retrospective single health system study, there was no difference in key outcomes including inpatient or 30-day mortality in patients admitted with sepsis and reported PcnA compared with patients who reported no PcnA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-050879","type":"journal-article","created":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T12:37:15Z","timestamp":1645619835000},"page":"e050879","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Outcomes in hospitalised patients with sepsis, severe sepsis or septic shock and reported penicillin allergy: a retrospective cohort study"],"prefix":"10.1136","volume":"12","author":[{"given":"David","family":"Beddow","sequence":"first","affiliation":[{"name":"Internal Medicine, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6271-6376","authenticated-orcid":false,"given":"Love","family":"Patel","sequence":"additional","affiliation":[{"name":"Internal Medicine, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire S","family":"Smith","sequence":"additional","affiliation":[{"name":"Care Delivery Research, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Kirven","sequence":"additional","affiliation":[{"name":"Internal Medicine, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Ruppman","sequence":"additional","affiliation":[{"name":"Internal Medicine, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Kethireddy","sequence":"additional","affiliation":[{"name":"Internal Medicine, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wankum","sequence":"additional","affiliation":[{"name":"Pharmacy, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barite","family":"Dawud","sequence":"additional","affiliation":[{"name":"Care Delivery Research, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6113-5705","authenticated-orcid":false,"given":"Catherine A","family":"St. Hill","sequence":"additional","affiliation":[{"name":"Care Delivery Research, Allina Health, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,2,23]]},"reference":[{"key":"2025121603051828000_12.2.e050879.1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(18)30696-2","article-title":"Sepsis and septic shock","volume":"392","author":"Cecconi","year":"2018","journal-title":"The Lancet"},{"key":"2025121603051828000_12.2.e050879.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"2025121603051828000_12.2.e050879.3","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200107000-00002"},{"key":"2025121603051828000_12.2.e050879.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2016.11.006"},{"key":"2025121603051828000_12.2.e050879.5","unstructured":"Torio CM , Moore BJ . National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013: Statistical Brief #204. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. US: Agency for Healthcare Research and Quality, 2006. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK368492\/"},{"key":"2025121603051828000_12.2.e050879.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1553"},{"key":"2025121603051828000_12.2.e050879.7","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002255"},{"key":"2025121603051828000_12.2.e050879.8","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000330"},{"key":"2025121603051828000_12.2.e050879.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1703058"},{"key":"2025121603051828000_12.2.e050879.10","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3287"},{"key":"2025121603051828000_12.2.e050879.11","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.18.2819"},{"key":"2025121603051828000_12.2.e050879.12","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1097\/ACI.0000000000000173","article-title":"Penicillin allergy: optimizing diagnostic protocols, public health implications, and future research needs","volume":"15","author":"Macy","year":"2015","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"2025121603051828000_12.2.e050879.13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03510200062033"},{"key":"2025121603051828000_12.2.e050879.14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.19283"},{"key":"2025121603051828000_12.2.e050879.15","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1177\/0897190015587254","article-title":"Allergic reactions in hospitalized patients with a self-reported penicillin allergy who receive a cephalosporin or meropenem","volume":"30","author":"Crotty","year":"2017","journal-title":"J Pharm Pract"},{"key":"2025121603051828000_12.2.e050879.16","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.iac.2017.07.001","article-title":"Penicillin and beta-lactam hypersensitivity","volume":"37","author":"Har","year":"2017","journal-title":"Immunol Allergy Clin North Am"},{"key":"2025121603051828000_12.2.e050879.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2011.05.035"},{"key":"2025121603051828000_12.2.e050879.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32218-9"},{"key":"2025121603051828000_12.2.e050879.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.09.021"},{"key":"2025121603051828000_12.2.e050879.20","doi-asserted-by":"crossref","first-page":"2276","DOI":"10.1016\/j.clinthera.2017.09.012","article-title":"Impact of penicillin allergy on time to first dose of antimicrobial therapy and clinical outcomes","volume":"39","author":"Conway","year":"2017","journal-title":"Clin Ther"},{"key":"2025121603051828000_12.2.e050879.21","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1093\/cid\/cix794","article-title":"The impact of a reported penicillin allergy on surgical site infection risk","volume":"66","author":"Blumenthal","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2025121603051828000_12.2.e050879.22","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.1093\/cid\/ciu542","article-title":"Core elements of hospital antibiotic stewardship programs from the centers for disease control and prevention","volume":"59 Suppl 3","author":"Pollack","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2025121603051828000_12.2.e050879.23","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S1081-1206(10)60882-4","article-title":"Penicillin skin testing in patients with a history of \u03b2-lactam allergy","volume":"98","author":"del Real","year":"2007","journal-title":"Annals of Allergy, Asthma & Immunology"},{"key":"2025121603051828000_12.2.e050879.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2010.08.002"},{"key":"2025121603051828000_12.2.e050879.25","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010","volume":"59","author":"Verani","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2025121603051828000_12.2.e050879.26","first-page":"3","article-title":"Approved: new antimicrobial stewardship standard","volume":"36","year":"2016","journal-title":"Jt Comm Perspect"},{"key":"2025121603051828000_12.2.e050879.27","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1017\/ice.2019.136","article-title":"Improved mortality in Staphylococcus aureus bacteremia with the involvement of antimicrobial stewardship team and infectious disease consultation","volume":"40","author":"Sherbuk","year":"2019","journal-title":"Infect Control Hosp Epidemiol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-050879","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:05:23Z","timestamp":1765883123000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-050879"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,23]]},"published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1136\/bmjopen-2021-050879"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-050879","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2]]}}}