Abstract
Objective: To evaluate antibiotic selection and the cost effect of reported β-lactam allergies. Design: Retrospective medical records review comparing antimicrobial selection and costs in patients with a reported β-lactam allergy with a group in which no such allergy had been documented. Setting: University-based family medicine clinic. Patients: Patients who were prescribed at least 1 antibiotic for an upper respiratory tract infection, otitis media, sinusitis, and/or a urinary tract infection were eligible. One thousand two hundred one patients were identified via ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes. Four hundred sixty-five patients were initially identified and an additional 195 family members were eligible for inclusion. Main Outcome Measures: Comparison of antimicrobial selection and costs (by average wholesale price) between patients with and without a reported β-lactam allergy. Results: Of the 660 patients eligible for inclusion, 99 (15%) had a documented β-lactam allergy. Of the patients with a documented allergy, only 33% had a description of their purported reaction. The mean antibiotic cost for patients with a β-lactam allergy was significantly higher compared with those without a β-lactam allergy ($26.81 vs $16.28, respectively; P = .004). Patients with a β-lactam allergy were more likely to have received a cephalosporin, macrolide, or a miscellaneous agent (eg, quinolone, tetracycline, or nitrofurantoin) (P = .001). Conclusions: Patients with a β-lactam allergy had higher antibiotic costs and were more likely to receive a broader-spectrum antibiotic. Most patients with a reported allergy did not have a description of their reaction. Skin testing may be of use in detecting true β-lactam allergies; however, further study is needed to determine its cost-effectiveness.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 722-726 |
| Number of pages | 5 |
| Journal | Archives of Family Medicine |
| Volume | 9 |
| Issue number | 8 |
| State | Published - 2000 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
Costs of β-lactam allergies : Selection and costs of antibiotics for patients with a reported β-lactam allergy. / MacLaughlin, E. J.; Saseen, J. J.; Malone, Daniel C.
In: Archives of Family Medicine, Vol. 9, No. 8, 2000, p. 722-726.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Costs of β-lactam allergies
T2 - Selection and costs of antibiotics for patients with a reported β-lactam allergy
AU - MacLaughlin, E. J.
AU - Saseen, J. J.
AU - Malone, Daniel C
PY - 2000
Y1 - 2000
N2 - Objective: To evaluate antibiotic selection and the cost effect of reported β-lactam allergies. Design: Retrospective medical records review comparing antimicrobial selection and costs in patients with a reported β-lactam allergy with a group in which no such allergy had been documented. Setting: University-based family medicine clinic. Patients: Patients who were prescribed at least 1 antibiotic for an upper respiratory tract infection, otitis media, sinusitis, and/or a urinary tract infection were eligible. One thousand two hundred one patients were identified via ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes. Four hundred sixty-five patients were initially identified and an additional 195 family members were eligible for inclusion. Main Outcome Measures: Comparison of antimicrobial selection and costs (by average wholesale price) between patients with and without a reported β-lactam allergy. Results: Of the 660 patients eligible for inclusion, 99 (15%) had a documented β-lactam allergy. Of the patients with a documented allergy, only 33% had a description of their purported reaction. The mean antibiotic cost for patients with a β-lactam allergy was significantly higher compared with those without a β-lactam allergy ($26.81 vs $16.28, respectively; P = .004). Patients with a β-lactam allergy were more likely to have received a cephalosporin, macrolide, or a miscellaneous agent (eg, quinolone, tetracycline, or nitrofurantoin) (P = .001). Conclusions: Patients with a β-lactam allergy had higher antibiotic costs and were more likely to receive a broader-spectrum antibiotic. Most patients with a reported allergy did not have a description of their reaction. Skin testing may be of use in detecting true β-lactam allergies; however, further study is needed to determine its cost-effectiveness.
AB - Objective: To evaluate antibiotic selection and the cost effect of reported β-lactam allergies. Design: Retrospective medical records review comparing antimicrobial selection and costs in patients with a reported β-lactam allergy with a group in which no such allergy had been documented. Setting: University-based family medicine clinic. Patients: Patients who were prescribed at least 1 antibiotic for an upper respiratory tract infection, otitis media, sinusitis, and/or a urinary tract infection were eligible. One thousand two hundred one patients were identified via ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes. Four hundred sixty-five patients were initially identified and an additional 195 family members were eligible for inclusion. Main Outcome Measures: Comparison of antimicrobial selection and costs (by average wholesale price) between patients with and without a reported β-lactam allergy. Results: Of the 660 patients eligible for inclusion, 99 (15%) had a documented β-lactam allergy. Of the patients with a documented allergy, only 33% had a description of their purported reaction. The mean antibiotic cost for patients with a β-lactam allergy was significantly higher compared with those without a β-lactam allergy ($26.81 vs $16.28, respectively; P = .004). Patients with a β-lactam allergy were more likely to have received a cephalosporin, macrolide, or a miscellaneous agent (eg, quinolone, tetracycline, or nitrofurantoin) (P = .001). Conclusions: Patients with a β-lactam allergy had higher antibiotic costs and were more likely to receive a broader-spectrum antibiotic. Most patients with a reported allergy did not have a description of their reaction. Skin testing may be of use in detecting true β-lactam allergies; however, further study is needed to determine its cost-effectiveness.
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UR - http://www.scopus.com/inward/citedby.url?scp=0033891346&partnerID=8YFLogxK
M3 - Article
C2 - 10927711
AN - SCOPUS:0033891346
VL - 9
SP - 722
EP - 726
JO - Archives of Family Medicine
JF - Archives of Family Medicine
SN - 1063-3987
IS - 8
ER -