A real-time prospective evaluation of clinical pharmaco-economic impact of diagnostic label of 'penicillin allergy' in a UK teaching hospital
A real-time prospective evaluation of clinical pharmaco-economic impact of diagnostic label of 'penicillin allergy' in a UK teaching hospital
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DOI：
10.1136/jclinpath-2014-202438
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发表时间：
2014-12-01
影响因子：
3.4
通讯作者：
Pillay, D.
中科院分区：
文献类型：
--
作者：
Li, M.;Krishna, M. T.;Pillay, D.
Aims To perform a pharmacological-economic analysis of prescribing alternative antibiotics in patients with a diagnosis label of“penicillin allergy”and assess whether the collection of information from a structured history and liaison with the family physician could reduce costs.Methods A prospective pro-forma based interview of randomly selected inpatients and their family physician was used to assess the validity of the diagnosis label of“penicillin allergy”.结果102例患者中，仅有40%（n=41）的患者有青霉素过敏史，40%（n = 41）的患者可能为“非过敏”，20%（n=20）的患者有“不确定”的反应。青霉素过敏患者的抗生素处方的总成本是1.82-2.58倍，比一线antibiots.Conclusions获得一个结构化的历史，从病人和家庭医生单独可以使青霉素过敏状态的准确识别。二线抗生素的总采购成本高于一线抗生素。
Aims To perform a pharmaco-economic analysis of prescribing alternative antibiotics in patients with a diagnostic label of 'penicillin allergy' and assess whether collation of information from a structured history and liaison with the family physician could reduce costs.Methods A prospective pro-forma-based interview of randomly selected in-patients and their family physician was used to assess the validity of the diagnostic label of 'penicillin allergy'. Cost analysis of prescription of alternative antibiotics was performed and compared with first-line agents.Results 102 patients were assessed and only 40% (n=41) were found to have a history consistent with penicillin hypersensitivity, 40% (n=41) were likely 'not allergic' and 20% (n=20) had 'indeterminate' reactions. Total cost of antibiotics prescribed for patients with penicillin allergy was 1.82-2.58-fold higher than for first-line antibiotics.Conclusions Obtaining a structured history from the patient and family physician alone can enable an accurate identification of penicillin allergy status. Total acquisition cost of second-line antibiotics is higher than if these patients were prescribed first-line antibiotics.