The following is a summary of “Impact of Penicillin Allergy Label on Clinical Outcomes of Pneumonia in Children,” published in the June 2023 issue of Allergy and Clinical Immunology by Kaminsky et al.

In approximately 5% of children, a penicillin (PCN) allergy label influences antibiotic selection and lengthens hospital stays. To the best of researchers’ knowledge, PCN allergy labels’ effect on pneumonia’s clinical outcomes in children is poorly understood. This study aims to examine PCN allergy labels’ effect on childhood pneumonia’s clinical outcomes. 

In this propensity score–matched cohort study, they compared the 30-day risk of hospitalization, the need for an intensive level of care, and acute respiratory failure from pneumonia among pediatric patients (aged 1 to 17 years) with and without a PCN allergy label after matching the 2 cohorts for demographic and medical comorbidities. In addition, prescription patterns for antibiotics were compared. PCN allergy label was associated with a higher risk of hospitalization (RR, 1.15; 95% CI, 1.07-1.23), acute respiratory failure (RR, 1.27; 95% CI, 1.17-1.39), and need for an intensive level of care (RR, 1.46; 95% CI, 1.15-1.84). 

PCN allergy label led to overuse of broad-spectrum antibiotics and increased complications, such as cutaneous drug reactions (RR, 2.43; 95% CI, 1.31-4.52) and Clostridioides difficile infection (RR, 2.25; 95% CI, 1.14-4.44). Children with a PCN allergy label are more likely to be hospitalized, receive antibiotics with a broader spectrum, and develop pneumonia with acute respiratory failure. Delabeling may offer a means to reduce morbidity from childhood pneumonia.

Source: sciencedirect.com/science/article/abs/pii/S2213219823003021