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 69-year-old male with CKD Stage III and psoriatic arthritis on adalimumab (40 mg every 2 weeks) and methotrexate (20mg weekly) presents to the hospital after routine labs revealed macrocytic anemia and neutropenia. The patient was treated for right hand cellulitis 10 days ago in an urgent care setting with a dose of [...]

Case Presentation: A 68 year old male with a history of end stage renal disease (ESRD) on hemodialysis, s/p cardiac transplant for refractory ischemic cardiomyopathy, and Cerebrovascular accident presented to the emergency department (ED) with fevers, lethargy and penile discharge. In the ED, he ws noted to be febrile with a temperature of 102.7 ºF.  He had no frank hematuria, flank pain, chest pain, [...]

Case Presentation: A 69 y/o male with no known PMH with a complicated hospital course highlighted by PE s/p TPA, AWSTEMI s/p DES to pLAD and septic shock leading to AKI requiring CVVH. For septic shock, Vancomycin, Zosyn, Ertapenem, and Ceftriaxone were started empirically. Infectious workup was only remarkable for klebsiella UTI which was found sensitive [...]