Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, Melbourne, Australia.
Infect Control Hosp Epidemiol. 2020 Jun;41(6):641-644. doi: 10.1017/ice.2020.53.
To determine the prevalence of antibiotic allergy labels (AALs) in Australian aged care residents and to describe the impact of labels on antibiotic prescribing practices.
Point-prevalence survey.
Australian residential aged care facilities.
We surveyed 1,489 residents in 407 aged care facilities.
Standardized data were collected on a single day between June 1 and August 31, 2018, for residents prescribed an antibiotic. An AAL was reported if it was documented in the resident's health record. Resident-level data were used to calculate overall prevalence, and antibiotic-level data were used to report relative frequency of AALs for individual antibiotics and classes.
Among 1,489 residents, 356 (24%) had 1 or more documented AALs. The AALs for penicillin (28.3%), amoxicillin or amoxicillin/clavulanic acid (10.5%), cefalexin (7.2%), and trimethoprim (7.0%) were most commonly reported. The presence of an AAL was associated with significantly less prescribing of penicillins (OR, 0.43; 95% CI, 0.31-0.62; P < .001) and significantly more prescribing of lincosamides (OR, 4.81; P < .001), macrolides (OR, 2.03; P = .007), and tetracyclines (OR, 1.54; P = .033). Of residents with AALs, 7 residents (1.9%) were prescribed an antibiotic that was listed on the allergy section of their health record.
A high prevalence of AALs was observed among residents of Australian aged care facilities, comparable to the prevalence of AALs in high-risk hospitalized patients. Significant increases in prescribing of lincosamide, macrolide, and tetracycline agents poses a potential risk to aged populations, and future studies must evaluate the benefits of AAL delabelling programs tailored for aged care settings.
确定澳大利亚老年护理居民中抗生素过敏标签（AAL）的流行率，并描述标签对抗生素处方实践的影响。
点患病率调查。
澳大利亚养老院。
我们调查了 407 家养老院的 1489 名居民。
2018 年 6 月 1 日至 8 月 31 日，对服用抗生素的居民进行了标准化数据收集。如果在居民的健康记录中记录了 AAL，则报告 AAL。使用居民水平的数据计算总体流行率，并使用抗生素水平的数据报告单个抗生素和类别的 AAL 相对频率。
在 1489 名居民中，有 356 名（24%）有 1 个或多个记录的 AAL。青霉素（28.3%）、阿莫西林或阿莫西林/克拉维酸（10.5%）、头孢氨苄（7.2%）和甲氧苄啶（7.0%）的 AAL 报告最为常见。存在 AAL 与青霉素的处方明显减少显著相关（OR，0.43；95%CI，0.31-0.62；P <.001），而林可酰胺类（OR，4.81；P <.001）、大环内酯类（OR，2.03；P =.007）和四环素类（OR，1.54；P =.033）的处方明显增加。在有 AAL 的居民中，有 7 名居民（1.9%）被开了一种在他们健康记录的过敏部分列出的抗生素。
在澳大利亚养老院居民中观察到 AAL 的高流行率，与高危住院患者的 AAL 流行率相当。林可酰胺类、大环内酯类和四环素类药物处方的显著增加对老年人群构成了潜在风险，未来的研究必须评估针对老年护理环境量身定制的 AAL 去标签计划的益处。
