Penicillin skin testing can ID tolerance to beta-lactam agents

(HealthDay)—Penicillin skin testing (PST) can be used to identify whether patients will tolerate β-lactam, with a negative predictive value of 100 percent, according to a study published in the June issue of the Journal of Hospital Medicine.

Ramzy H. Rimawi, M.D., from the Brody School of Medicine-East Carolina University in Greenville, N.C., and colleagues described the negative predictive value of PST and its impact on antibiotic selection in a sample of 146 patients with a reported history consistent with penicillin allergy and with negative PST. Patients were transitioned to treatment with a β-lactam agent.

The researchers found that only one of the patients experienced an allergic reaction to the PST. The remaining patients tolerated a full course of β-lactam therapy, with no evidence of allergic response. The negative predictive value for PST was 100 percent. PST-guided antibiotic alteration resulted in an estimated saving of $82,000 annually.

"Patients with a history of penicillin allergy who have a negative PST result are at a low risk of developing an immediate-type hypersensitivity reaction to β-lactam antibiotics," the authors write. "The increased use of PST may help improve antibiotic stewardship in the hospital setting."

One author disclosed financial ties to the pharmaceutical industry.

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