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1 Credit CME

Penicillin allergy is often diagnosed early in life, and the history of penicillin allergy persists in a patient’s medical record for many years without verification. Some physicians’ consideration of a patient having penicillin allergy is based on patient experience that may have occurred early in childhood. This results in the use of alternate antibiotics that are less effective, more toxic and expensive, and that have inappropriately broader coverage than penicillin.1 Accumulating evidence suggests that excessive use of unnecessarily broad-spectrum antibiotics increases the risk of antibiotic resistance, including Clostridium difficile infection.2 The inability to use an antistaphylococcal penicillin (eg, nafcillin) for patients with methicillin-susceptible Staphylococcus aureus sepsis or other serious infections for which penicillins are the first-line therapy (eg, ampicillin for Enterococcus faecalis or benzathine penicillin for syphilis) places patients at risk of treatment failure, resistance generation, and increased mortality.

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Article Information

Corresponding Author: Elizabeth J. Phillips, MD, Vanderbilt University Medical Center, Oates Institute for Experimental Therapeutics 1161 21st Ave S, A-2200 Medical Center N, Nashville, TN 37232-2582 (elizabeth.j.phillips@vanderbilt.edu).

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Trubiano reports receipt of support from a National Health and Medical Research Council of Australia (NHMRC) postgraduate research scholarship. Dr Adkinson reports being a founding partner in Allerquest. Dr Phillips reports receipt of consultancy fees from Biocryst and Aicuris, grants from the National Institutes of Health and the NHMRC, and royalties from Uptodate. No other disclosures were reported.

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