Background: Penicillin discovered in 1928 by Sir Alexander Fleming, beginning of the antibiotic revolution. Penicillin as helped increase average life Span in USA from 47 years to 78.8 years. Beta lactam account to about 40% of total antibiotic use every year. 10% of patients in U.S. report penicillin allergy, but 9 out of 10 patients […]

Background: Penicillin discovered in 1928 by Sir Alexander Fleming, beginning of the antibiotic revolution. Penicillin as helped increase average life Span in USA from 47 years to 78.8 years. Beta lactam account to about 40% of total antibiotic use every year. 10% of patients in U.S. report penicillin allergy, but 9 out of 10 patients […]

Background: Heparin‐induced thrombocytopenia (HIT) is a clinicopathologic process that is the end result of antibodies directed at platelet factor 4–heparin complexes. The clinical findings can be subtle or dramatic, and serologic confirmation is problematic. Current screening immunoassays, although sensitive, have poor specificit,y resulting in an overdiagnosis of HIT. Because of this poor specificity, all positive […]

Background: Pregnant patients labeled with a penicillin allergy (PcnA) and charted as Group B streptococcus (GBS) positive can spread this infection to their baby during a vaginal delivery resulting in serious illness for their newborns. GBS is the most common cause of infectious morbidity and mortality in the neonatal period during the first week of […]

Background: For many patients, hospitalization involves substantial inactive time between provider visits, tests, and treatments. This time could be used to engage patients in discharge preparation by (1) learning about their health conditions and (2) learning to use their personal health record (PHR) to manage medications and postdischarge appointments. The ease of use of tablet […]

Background: In the United States, 32 million people have a documented penicillin allergy and up to 20% of hospitalized patients’ records describe a penicillin allergy (PcnA). Less than 10% of patients with reported penicillin allergy have true clinically relevant PcnA when objectively tested through rigorous skin testing (1-3). Clinicians subsequently avoid appropriate penicillin or penicillin […]

Background: Penicillin class antibiotics are the most frequently reported drug allergy in the electronic health record (EHR), but recent studies find

Case Presentation: A 42‐year‐old woman with HIV/AIDS (CD4 count, 40 cells/mm3) presented with fever, nausea, and headaches for 1 week. She was febrile at 101.4°F but her physical exam was unremarkable. Initial labs showed leukopenia and anemia. Infectious workup including blood cultures, cerebrospinal fluid analysis, chest x‐ray, and urine cultures were negative. During her hospital […]

Case Presentation: A 24‐year‐old woman 25 weeks' pregnant with a history of nephrotic syndrome was admitted for diabetic ketoacidosis and pneumonia. On day 4, she delivered a nonviable fetus, which was followed by flash pulmonary edema due to an inferior‐wall MI. Cardiac catheterization was suggestive of right coronary artery embolus. On day 8, she developed […]

Background: Self-reported penicillin (PCN) allergy affects 7-10% of the community population and affects almost 20% of hospitalized patients nationally [1,2]. Mislabeling of side effects (gastrointestinal symptoms) or coincidental events (headache) as a true allergic reaction (IgE-mediated type I hypersensitivity) contributes largely to statistics. In recent studies, the rate of positive skin test results to PCN […]