RT Journal Article SR Electronic T1 A real-time prospective evaluation of clinical pharmaco-economic impact of diagnostic label of ‘penicillin allergy’ in a UK teaching hospital JF Journal of Clinical Pathology JO J Clin Pathol FD BMJ Publishing Group Ltd and Association of Clinical Pathologists SP 1088 OP 1092 DO 10.1136/jclinpath-2014-202438 VO 67 IS 12 A1 M Li A1 M T Krishna A1 S Razaq A1 D Pillay YR 2014 UL http://jcp.bmj.com/content/67/12/1088.abstract AB Aims To perform a pharmaco-economic analysis of prescribing alternative antibiotics in patients with a diagnostic label of ‘penicillin allergy’ and assess whether collation of information from a structured history and liaison with the family physician could reduce costs. Methods A prospective pro-forma-based interview of randomly selected in-patients and their family physician was used to assess the validity of the diagnostic label of ‘penicillin allergy’. Cost analysis of prescription of alternative antibiotics was performed and compared with first-line agents. Results 102 patients were assessed and only 40% (n=41) were found to have a history consistent with penicillin hypersensitivity, 40% (n=41) were likely ‘not allergic’ and 20% (n=20) had ‘indeterminate’ reactions. Total cost of antibiotics prescribed for patients with penicillin allergy was 1.82–2.58-fold higher than for first-line antibiotics. Conclusions Obtaining a structured history from the patient and family physician alone can enable an accurate identification of penicillin allergy status. Total acquisition cost of second-line antibiotics is higher than if these patients were prescribed first-line antibiotics.