Here is a really interesting study, per Jim Carpenter in Portland, on a very high documented true allergy rate of self reported Penicillin allergies in a ED. 91% of people that stated a PCN allergy did not have a IgE mediated response. Wow, that sounds high to me.
As Jim points out in his Twitter post, this may have significant implications for CDS alerting. Some logic based on the patients condition and infection where a PCN or Cephalosporin may be the best choice might invoke a suggestion to do a skin test to determine if a true allergy exists. The article has a table of potential cost savings.
http://www.annemergmed.com/webfiles/images/journals/ymem/asraja.pdf
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