Introduction
Patients with penicillin allergy records are usually prescribed non-penicillin antibiotics and have worse health outcomes. This study explored the impact of penicillin allergy records on antibiotic treatment costs and on patient length of stay.
Methods
Patients prescribed a systemic antibacterial agent between April 2016 and March 2018 in a 750 bed English hospital were included. The following data were extracted for each patient hospital spell; age, sex, co-morbidity, infection treated, antibiotic usage (DDD), hospital length of stay, and penicillin allergy status.
Multivariable log-linear modelling was used to determine the association between patients labelled as penicillin allergic and total antibiotic costs and length of stay.
Using the above models, we estimated the potential reduction in total costs and hospital bed days of ‘de-labelling’ patients with penicillin allergy records.
Results
Penicillin allergy records were present in 14.3% of hospital admissions and were associated with an increase in non-penicillin antibiotic prescribing, a 28.4% increase in antibiotic costs and 5.5% longer length of hospital stay, relative to patients without a penicillin allergy record. Patients with penicillin allergy records accounted for an excess antibiotic spend of £10,637 (2.61% of annual antibiotic drug spend) and 3,522 excess bed days (3.87% of annual bed days). De-labelling 50% of patients with a self-reported allergy record would save an estimated £5,501 in antibiotic costs and £503,932 through reduced excess bed days
Conclusion
De-labelling patients with a self-reported allergy record has potential to reduce antibiotic costs but its biggest cost impact is via reduction in excess bed days.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)