CoxaPro
> Clinical Library > Tervetuloa Clinical Libraryyn > Economic Burden of Patient-Reported Penicillin Allergy on Total Hip and Total Knee Arthroplasty
The Journal of Arthroplasty, ISSN: 0883-5403, Vol: 36, Issue: 9, Page: 3067-3072
Hip Knee
Link to article
Economic Burden of Patient-Reported Penicillin Allergy on Total Hip and Total Knee Arthroplasty
Olivia C. Lee; Darren C. Cheng; Jonathan L. Paul; Bailey J. Ross; Barrett J. Hawkins; William F. ShermanHip Knee
Introduction
Self-reported penicillin allergies in patients undergoing total joint arthroplasty often results in the use of second-line prophylactic antibiotics. A higher risk of prosthetic joint infection (PJI) is associated with suboptimal antibiotics vs first generation cephalosporins, which have historically been grouped with other beta-lactam antibiotics such as penicillin for potential allergic reactions. This study evaluates the economic burden of self-reported penicillin allergies in total joint arthroplasty (TJA).
Methods
Data from studies reporting true incidence of IgE-mediated penicillin allergies, infection-free survivorship of TJA, and cost of PJI attributed to use of second-line antibiotics were obtained. Projected cost of preoperative penicillin allergy testing and potentially avoidable PJI associated with second-line antibiotic usage were calculated. This was compared with projected cost of PJI in the current state to estimate cost savings.
Results
Implementation of preoperative penicillin allergy testing leads to a potential savings of nearly $37 million to payors in the first year based on 1-year survivorship. This savings increases to $411.6 million over a 10-year span and $1.18 billion over a 20-year span.
Conclusion
Preoperative penicillin allergy testing or risk stratification via thorough history should be implemented as standard of care for patients with self-reported penicillin allergies before TJA and would result in decreased cost of PJI.
Link to article