Impact of penicillin allergy records on antimicrobial prescribing in hospitalised patients.

Autor: Anton-Vazquez V; Medical Microbiology, Lewisham & Greenwich NHS Trust, London, UK. Electronic address: v.anton-vazquez@nhs.net., Ferretti F; Medical Microbiology, Lewisham & Greenwich NHS Trust, London, UK., Kaya D; General Internal Medicine, Lewisham & Greenwich NHS Trust, London, UK., Mishra S; General Internal Medicine, Lewisham & Greenwich NHS Trust, London, UK., Kerneis S; General Internal Medicine, Lewisham & Greenwich NHS Trust, London, UK., Eden C; General Internal Medicine, Lewisham & Greenwich NHS Trust, London, UK., Doan H; General Internal Medicine, Lewisham & Greenwich NHS Trust, London, UK., Leung HF; Antimicrobial pharmacy, Lewisham & Greenwich NHS Trust, London, UK., Baltazar J; Antimicrobial pharmacy, Lewisham & Greenwich NHS Trust, London, UK., Starkey S; Medical Microbiology, Lewisham & Greenwich NHS Trust, London, UK., Uwagwu J; Medical Microbiology, Lewisham & Greenwich NHS Trust, London, UK., Dall'Antonia M; Medical Microbiology, Lewisham & Greenwich NHS Trust, London, UK., Cepeda J; Medical Microbiology, Lewisham & Greenwich NHS Trust, London, UK.
Jazyk: angličtina
Zdroj: Clinical medicine (London, England) [Clin Med (Lond)] 2024 Mar; Vol. 24 (2), pp. 100024. Date of Electronic Publication: 2024 Feb 20.
DOI: 10.1016/j.clinme.2024.100024
Abstrakt: Background: The overdiagnosis of penicillin allergy and misclassification of non-truly allergic reactions is a growing public health problem, associated with the overuse of broad-spectrum and restricted antimicrobials. We aimed to evaluate the impact of penicillin allergy status on antimicrobial prescribing.
Methods: A retrospective study of inpatients with a documented penicillin allergy receiving antimicrobials was conducted from 1 April to 1 July 2021. Antimicrobial prescribing and clinical characteristics were compared between patients with an active penicillin allergy label and those whose label was removed following antimicrobial stewardship team review. Antimicrobials were classified in two categories: i) 'Access' (recommended), ii) 'Watch and Reserve' (restricted) according to WHO AWaRe classification, a tool to guide appropriate antibiotic use.
Results: 437 patients with a documented penicillin allergy receiving antimicrobials were included. 353 patients with an active penicillin allergy label, more frequently received antimicrobials from the 'Watch and Reserve list' (283;80% vs 30;37%; p<0.001). In contrast, 84 patients who were de-labelled received more often antimicrobials from the 'Access list' (53;63% vs 64;18%; p<0.001).
Conclusions: Penicillin allergy reviews and de-labelling strategies may reduce the use of restricted antimicrobials under the 'Watch and Reserve list'. This practice should be encouraged and reinforced in all hospitals.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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