Delabeling of allergy to beta-lactam antibiotics in hospitalized patients: A prospective study evaluating cost savings.

Abstract

Abstract Background Patients with a penicillin allergy label have an associated increase in adverse antibiotic events and hospitalization costs. Aim We aimed to study the economic savings derived from the correct diagnosis and delabeling of inpatients with suspected beta-lactam allergy. Method We prospectively evaluated patients admitted to the University Hospital of Salamanca who had been labeled as allergic to beta-lactams and performed a delabeling study on them. Subsequently, the difference in costs between the antibiotics administered before and after the allergy study and between the costs derived from those patients who received alternative antibiotics during admission and those who switched to beta-lactams after the allergy study were calculated. Results One hundred seventy-seven inpatients labeled as allergic to beta-lactams underwent a delabeling study, and 34 (19.2%) of them were confirmed to have an allergy to beta-lactams. Of the total number of patients, 136 (76.8%) received antibiotic treatment during their hospitalization involving a mean (SD) cost of €203.07 (318.42). After delabeling, in 85 (62.5%) patients the antibiotic treatment was changed to beta-lactams. In this group of patients, the mean cost (SD) then decreased from €188.91 (351.09) before the change to 91.31 (136.07) (p < 0.001) afterward, so the mean cost (SD) total decreased in these patients to €142.07 (200.50), p = 0.000. This cost reduction was also significant when compared to the mean (SD) cost of patients in whom treatment was not changed to beta-lactams (€226.66 (256.43)) (p < 0.001). Conclusions Delabeling hospitalized patients, when possible, represents a cost-saving measure for treating patients labeled as allergic to beta-lactams.