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

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Abstract

Background

Patients with a penicillin allergy label are at risk of 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 inpatients with suspected beta-lactam allergy, considering the acquisition cost of antimicrobials prescribed during a patient's hospital stay.

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. Subsequently, cost differences between antibiotics administered before and after the allergy study and those 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; 34 (19.2%) were confirmed to have allergy to beta-lactams. Of the total number of patients, 136 (76.8%) received antibiotics during their hospitalization, involving a mean (SD) cost of €203.07 (318.42) and a median (IQR) cost of €88.97 (48.86–233.56). After delabeling in 85 (62.5%) patients, the antibiotic treatment was changed to beta-lactams. In this group of patients, the mean cost (SD) decreased from €188.91 (351.09) before the change to 91.31 (136.07) afterward, and the median cost (IQR) decreased from €72.92 (45.82–211.99) to €19.24 (11.66–168). The reduction was significant compared to the median cost of patients whose treatment was not changed to beta-lactams (p<0.001).

Conclusion

Delabeling hospitalized patients represents a cost-saving measure for treating patients labeled as allergic to beta-lactams.

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Acknowledgements

We would like to thank the nursing staff of the Allergy Service of the University Hospital of Salamanca for their work in carrying out the allergic study and the i2e3 Biomedical Research Institute for providing medical writing assistance on behalf of Allergy Therapeutics (BEC-AT).

Funding

This study has been funded by the project RICORS-REI RD21/0002/0054, funded by Instituto de Salud Carlos III (ISCIII) and European Union -NextGeneration EU. Miriam Sobrino-García declares the following financial interests/personal relationships which may be considered as potential competing interests: “Juan Rodés” Clinical Research Contract (JR22/00050) for this research project, financed by the Carlos III Health Institute, and writing assistance provided by i2e3 Biomedical Research Institute, financed by Allergy Therapeutics Ibérica®.

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Authors and Affiliations

  1. Allergy Service, University Hospital of Salamanca, Salamanca, Castilla y León, Spain

    Miriam Sobrino-García, Francisco J. Muñoz-Bellido, Esther Moreno-Rodilla & Ignacio Dávila

  2. Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Castilla y León, Spain

    Miriam Sobrino-García, Francisco J. Muñoz-Bellido, Esther Moreno-Rodilla & Ignacio Dávila

  3. Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Castilla y León, Spain

    Francisco J. Muñoz-Bellido, Esther Moreno-Rodilla & Ignacio Dávila

  4. Red de Enfermedades Inflamatorias - Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain

    Francisco J. Muñoz-Bellido, Esther Moreno-Rodilla & Ignacio Dávila

  5. Hospital Pharmacy Service, University Hospital of Salamanca, Salamanca, Castilla y León, Spain

    Rita Martín-Muñoz

  6. Admission and Clinical Documentation Service, University Hospital of Salamanca, Salamanca, Castilla y León, Spain

    Aránzazu García-Iglesias

  7. Servicio de Alergología, Hospital Universitario de Salamanca, Paseo de La Transición Española, 37007, Salamanca, Spain

    Francisco J. Muñoz-Bellido

Authors
  1. Miriam Sobrino-García
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  2. Francisco J. Muñoz-Bellido
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  3. Esther Moreno-Rodilla
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  4. Rita Martín-Muñoz
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  5. Aránzazu García-Iglesias
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  6. Ignacio Dávila
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Corresponding author

Correspondence to Francisco J. Muñoz-Bellido.

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Conflicts of interest

Ignacio Dávila, In the last three years, has received payment for lectures, including service on speaker’s bureaus from Allergy Therapeutics, Astra-Zeneca, Chiesi, Diater, GSK, Leti, Novartis, Sanofi; for a consultancy from Allergy Therapeutics, ALK-Abello, Astra-Zeneca, GSK, Merck, MSD, Novartis, Sanofi; and grants for Thermofisher Diagnostics, ISCIII and Junta de Castilla y León. Francisco J. Muñoz-Bellido, Esther Moreno-Rodilla, Rita Martín-Muñoz and Aránzazu García-Iglesias have no conflicts of interest to declare.

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Sobrino-García, M., Muñoz-Bellido, F.J., Moreno-Rodilla, E. et al. Delabeling of allergy to beta-lactam antibiotics in hospitalized patients: a prospective study evaluating cost savings. Int J Clin Pharm (2024). https://doi.org/10.1007/s11096-024-01737-7

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