On behalf of the millions of Texas residents labeled penicillin-allergic, I am writing to request that a proclamation be issued this year for NATIONAL PENICILLIN ALLERGY DAY, September 28, 2018.

Allergy to penicillin and related antibiotics is the most commonly reported drug allergy in the United States.¹ A study which evaluated patients of UT Southwestern in Dallas who identified as penicillin-allergic found that approximately 90.5% of those patients were not truly allergic when evaluated with penicillin allergy skin testing.² This finding is on par with national estimates that 10% of patients self-report as being penicillin allergic; and that 9 out of 10 of these patients reporting penicillin allergy are not truly allergic.¹

This means that up to 2.5 MILLION Texans may be erroneously labeled as penicillin-allergic.

Why is this important?

• Carrying an inaccurate diagnosis of penicillin "allergy" could adversely affect the quantity and quality of healthcare used.³
• Patients labeled penicillin-allergic have a threefold increased risk of adverse events (ADE).⁴
• By some estimates, up to half of all hospitalized patients in the US receive antibiotics and up to half of antimicrobial use may be inappropriate.⁵ There is a causal relationship between inappropriate antimicrobial use and resistance; changes in antimicrobial use lead to parallel changes in the prevalence of resistance.⁶

With your support in declaring NATIONAL PENICILLIN ALLERGY DAY, we can continue to increase public awareness about false penicillin allergy. It is our objective to help educate both healthcare practitioners and the citizens of our state on the serious public health and economic implications of false penicillin allergies.

Please find below a draft of a proposed Proclamation for NATIONAL PENICILLIN ALLERGY DAY for September 28, 2018 to help build recognition and awareness for penicillin allergy and penicillin allergy testing. You may send the proclamation to:

[Your Organization]

Attn: [Your Name and/or Department]

[Street Address]

[City], [State] [Zip Code]

References:

1. Salkind, A. R., Cuddy, P. G., & Foxworth, J. W. (2001). Is This Patient Allergic to Penicillin? Jama,285(19), 2498. doi:10.1001/jama.285.19.2498
2. Chen, J. R., Tarver, S. A., Alvarez, K. S., Tran, T., & Khan, D. A. (2017). A Proactive Approach to Penicillin Allergy Testing in Hospitalized Patients. The Journal of Allergy and Clinical Immunology: In Practice, 5(3), 686-693. doi:10.1016/j.jaip.2016.09.045
3. Macy, E. M., & Contreras, R. (2014). Healthcare Utilization and Serious Infection Prevalence Associated With Penicillin “Allergy” In Hospitalized Patients: A Cohort Study. Journal of Allergy and Clinical Immunology, 133(2). doi:10.1016/j.jaci.2013.12.559
4. Blumenthal, K. G., & Shenoy, E. S. (2016). Editorial Commentary: Fortune Favors the Bold: Give a Beta-Lactam! Clinical Infectious Diseases, 63(7), 911-913. doi:10.1093/cid/ciw467
5. Owens, R. C., Fraser, G. L., & Stogsdill, P. (2004). Antimicrobial Stewardship Programs as a Means to Optimize Antimicrobial Use. Pharmacotherapy, 24(7), 896-908. doi:10.1592/phco.24.9.896.36101
6. Dellit, T. H. (2007). Summary of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. Infectious Diseases in Clinical Practice, 15(4), 263-264. doi:10.1097/ipc.0b013e318068b1c0

(TEMPLATE ONLY: PLEASE MODIFY TO YOUR NEEDS)

STATE PROCLAMATION FOR NATIONAL PENICILLIN ALLERGY DAY

SEPTEMBER 28, 2018

NATIONAL PENICILLIN ALLERGY DAY PROCLAMATION

WHEREAS, penicillin is the most commonly reported drug allergy with 10% of all US patients—or 30 million Americans—reporting having an allergic reaction to a penicillin-class antibiotic in their past¹; and

WHEREAS, penicillin allergy history is often inaccurate. Research shows that 9 out of 10 patients reporting as penicillin allergic are not truly allergic to penicillin¹; and

WHEREAS, inaccurate diagnosis of penicillin allergy can adversely impact medical costs for both patients and healthcare systems: research shows that as antibiotic costs for patients reporting penicillin allergies are up to 63% higher than for those who do not report being penicillin-allergic²; and

WHEREAS, in the hospital setting, history of penicillin allergy translates to about 10% more hospital days, 30% higher incidence of VRE infections, 23% higher incidence of C difficile infections, and 14% higher incidence of MRSA infections²; and

WHEREAS, these adverse events occur because penicillin “allergic” patients are given more broad spectrum antibiotics², which contributes to the public health problem of antibiotic resistance³; and

WHEREAS, National Penicillin Allergy Day was created to raise awareness of false penicillin allergy and encourage the de-labeling of patients falsely labeled with penicillin allergy by promoting the existence of penicillin allergy skin testing;

NOW, THEREFORE, I, Greg Abbott, Governor of the state of Texas, do hereby proclaim September 28, 2018: National Penicillin Allergy Day in the State of Texas and encourage the residents of Texas to increase their understanding and awareness of penicillin allergy.

References:

1. Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273
2. Macy, E. M., & Contreras, R. (2014). Healthcare Utilization and Serious Infection Prevalence Associated With Penicillin “Allergy” In Hospitalized Patients: A Cohort Study. Journal of Allergy and Clinical Immunology,133(2). http://dx.doi.org/10.1016/j.jaci.2013.09.021
3. Dellit, TH, Owens, RC, McGowan JE, Jr et al. Infectious Disease Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing Institutional Programs to Enhance Antimicrobial Stewardship. Clin Infect Dis. 2007;44-150-77.