Table 1.
Baseline Demographics, Clinical Characteristics, and Antibiotic Usage in Cancer vs Noncancer Patients Undergoing Oral Penicillin Challenge
| Patient Group | ||||
|---|---|---|---|---|
| Patient Characteristic | Cancer (n = 23) |
Noncancer (n = 23) |
Overall (n = 46) |
P Value |
| Age, median (IQR), y | 58 (44–71) | 52 (32–77) | 56 (42–74) | .80 |
| Male sex | 12 (52.17) | 9 (40.91) | 21 (46.67) | .45 |
| Age-adjusted CCI, median (IQR) | 4 (3–7) | 2 (1–4) | 3 (2–6) | .01 |
| Antibiotic allergy labels (n = 54) | 24 (44.4) | 30 (54.54) | 54 | |
| Penicillin | 23 (95.83) | 24 (80.0) | 47 (90.37) | .35 |
| Cephalosporin | 0 | 2 (6.66) | 2 (3.7) | |
| Macrolide | 1 (4.16) | 1 (3.33) | 2 (3.7) | |
| Sulfonamide | 0 | 2 (6.66) | 2 (3.7) | |
| Metronidazole | 0 | 1 (3.33) | 1 (1.85) | |
| Implicated penicillins | ||||
| Penicillin (unspecified) | 19 (82.6) | 15 (65.2) | 34 (74) | .21 |
| Amoxicillin | 4 (17.4) | 8 (34.7) | 39 (69.64) | |
| Amoxicillin clavulanate | 0 (0) | 1 (4.3) | 15 (26.79) | |
| Phenotype of implicated penicillins (n = 48) | ||||
| Childhood rash | 7 (30.43) | 5 (20.83) | 12 (25.53) | .23 |
| MPE <10 y before | 4 (17.39) | 10 (41.67) | 14 (29.79) | |
| Type A ADR | 1 (4.35) | 3 (12.5) | 4 (8.51) | |
| Unknown | 11 (47.83) | 6 (25.0) | 17 (36.17) | |
| Childhood penicillin allergy (age < 18 y) | 12 (52.17) | 9 (30.43) | 19 (41.30) | .31 |
| Avoiding penicillins | 23 (100) | 22 (95.65)a | 45 (97.83) | .31 |
| Avoiding cephalosporins | 9 (39.13) | 9 (39.13) | 18 (39.13) | 1 |
| Inpatient challenge | 10 (43.48) | 19 (82.60) | 29 (63.04) | .01 |
| Challenge antibiotics | ||||
| Penicillin single dose 250 mg | 15 (65.21) | 9 (39.13) | 24 (52.17) | 1 |
| Amoxicillin single dose 250 mg | 8 (34.78) | 16b (69.57) | 24 (52.17) | |
| Prolonged challenge (5 d) | 2 (8.69) | 7 (30.43) | 9 (39.13) | |
| Penicillin and amoxicillin challenge | 1 (4.34) | 0 | 1 (2.17) | |
| >1 antibiotic allergy label (any) | 1 (4.34) | 3 (13.04) | 4 (8.70) | .61 |
| Antibiotics administered | ||||
| 90 d pre | 13 (56.52) | 18 (78.26) | 31 (67.39) | .21 |
| 90 d post | 9 (39.13) | 17 (73.91) | 26 (60.46) | .04 |
| No. of antibiotic courses (> 1 antibiotic dose), median (IQR) | ||||
| 90 d pre (n = 51) | - | - | 1 (0–2) | .47 |
| 90 d post (n = 49) | 1 (0–2) | |||
| Adverse drug reactionsc | ||||
| 90 d post | 0 (0) | 0 (0) | 0 (0) | 1 |
| Penicillin (any) use in patients receiving antibiotics | ||||
| 90 d pre | 0 (0) | 1 (5.56) | 1 (3.2) | 1 |
| 90 d post | 7 (77.78) | 15 (88.24) | 22 (84.61) | .59 |
| Narrow-spectrum β-lactam in patients receiving antibioticsd | ||||
| 90 d pre | 0 (0) | 7 (38.89) | 7 (22.58) | .03 |
| 90 d post | 7 (77.78) | 13 (76.47) | 20 (76.92) | 1 |
| β-lactam/β-lactamase inhibitor use in patients receiving antibiotics | ||||
| 90 d pre | 0 (0) | 1 (5.56) | 1 (3.2) | 1 |
| 90 d post | 5 (55.56) | 8 (47.06) | 13 (0.5) | 1 |
| Third- or fourth-generation cephalosporin use in patients receiving antibiotics | ||||
| 90 d pre | 6 (26.08) | 10 (43.48) | 16 (34.8) | .35 |
| 90 d post | 1 (4.34) | 1 (4.34) | 2 (8.69) | 1 |
| Restricted antibiotic use in patients receiving antibioticse | ||||
| 90 d pre | 5 (38.46) | 12 (66.67) | 17 (54.88) | .15 |
| 90 d post | 4 (44.44) | 2 (11.76) | 6 (23.08) | .14 |
Unless otherwise stated, all values represent the number and proportion (%).
Abbreviations: ADR, adverse drug reaction; CCI, Charlson Comorbidity Index; IQR, interquartile range; MPE, maculopapular exanthema.
aOne patient was avoiding penicillins/aminopenicillins but had tolerated an unknown alternative penicillin.
bIncludes 1 prolonged oral challenge to amoxicillin-clavulanate.
cIncluded any reported adverse drug reaction in the medical record, non-immune- or immune-mediated.
dIncludes penicillin VK, penicillin G, flucloxacillin, amoxicillin, ampicillin, cefazolin, and cefalexin.
eIncludes fluoroquinolone, vancomycin, carbapenem, lincosamide or ≥third-generation cephalosporin