Department of Microbiology, NSW Health Pathology, Randwick, Australia.
Infectious Diseases Department, Prince of Wales Hospital, Randwick, Australia.
Asian Pac J Allergy Immunol. 2021 Jun;39(2):124-128. doi: 10.12932/AP-111217-0215.
Antibiotic allergy labels have a direct impact on individual patient care and on the consumption of broad-spectrum antibiotics.
Our aim was to establish the prevalence of antibiotic allergies and to determine whether patients with documented antibiotic allergy labels received guideline concordant antimicrobial therapy. Additionally we wanted to evaluate the quality of allergy documentation in the medical record.
Prospective audit of all patients presenting to the Emergency Department of an adult teaching hospital in Sydney over a 4 month period. Documented allergy labels, diagnoses, antibiotic administration and outcomes were recorded. Appropriateness of antibiotic choice was based on the Australian National Antimicrobial Prescribing Survey.
9.9% of presentations had at least one antibiotic allergy recorded. Significantly more women than men had antibiotic allergies documented. One third of patients with documented antibiotic allergies were prescibed inappropriate antibiotic therapy and some had significant adverse events.
The documentation of antibiotic allergy labels and choice of antibiotic treatment can be significantly improved. Strategies to safely de-label people with documented allergies who are not truly allergic need to be implemented.
抗生素过敏标签直接影响个体患者的护理和广谱抗生素的使用。
我们旨在确定抗生素过敏的流行率，并确定是否有记录过敏标签的患者接受了与指南一致的抗菌治疗。此外，我们还评估了病历中过敏记录的质量。
对悉尼一家成人教学医院急诊科在 4 个月期间就诊的所有患者进行前瞻性审核。记录了记录过敏标签、诊断、抗生素使用和结果。抗生素选择的适当性基于澳大利亚国家抗菌药物处方调查。
9.9%的就诊者至少有一个抗生素过敏记录。记录过敏的女性明显多于男性。三分之一有记录过敏标签的患者接受了不适当的抗生素治疗，一些患者出现了严重的不良反应。
抗生素过敏标签的记录和抗生素治疗的选择可以得到显著改善。需要实施策略以安全地标记那些并非真正过敏的有记录过敏的患者。
