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The following is a summary of “Association of Social Determinants of Health and Penicillin Allergy Labels: a case-control study,” published in the March 2025 issue of Clinical Infectious Diseases by Chow et al. 

Penicillin allergy labels (PAL) have been linked to adverse outcomes, including poor infectious outcomes and antimicrobial resistance.  

Researchers conducted a retrospective study to examine the association between SV, characterized by social determinants of health (SDoH), and PAL epidemiology.  

They included individuals at a US academic medical center (2014-2023). Cases had PAL, while controls had no PAL but had a penicillin medication order. The SV was measured using the Community Vulnerability Compass, incorporating 20 SV indicators. The primary outcome was PAL documentation. Bivariate analyses assessed associations between SV, covariates, and PAL.  

The results showed that 32,952 PAL cases and 171,189 controls were included (mean [SD] age, 36.3 [21.4] years; 107,498 [52.7%] Hispanic, 4,566 [2.2%] non-Hispanic Asian, 55,422 [27.1%] non-Hispanic Black, 31,680 [15.5%] non-Hispanic White). A higher SV quintile correlated with lower PAL prevalence (unadjusted odds ratio [OR], 0.52; 95%CI, 0.50-0.54). After adjusting for SV, non-Hispanic White identification remained significantly linked to PAL, while decreased PAL was observed in other groups (Hispanic aOR, 0.38; 95% CI, 0.36-0.41; non-Hispanic Black aOR, 0.45; 95% CI, 0.42-0.48; non-Hispanic Asian aOR, 0.40; 95% CI, 0.34-0.45).  

Investigators concluded that a significant inverse relationship between SV and PAL was observed, with lower SV associated with increased PAL, and significant racial disparities in PAL persisted despite adjusting for SDoH, suggesting differential interactions within the healthcare system regarding PAL acquisition among racial- and ethnic-identified groups. 

Source: academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciaf153/8099189