Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Western Australia, Australia.
Department of Emergency Medicine, Perth Children's Hospital, Perth, Western Australia, Australia.
J Paediatr Child Health. 2022 Aug;58(8):1414-1419. doi: 10.1111/jpc.16007. Epub 2022 May 3.
Penicillin allergy accounts for the majority of all reported adverse drug reactions in adults and children. Foregoing first-line antibiotic therapy due to penicillin allergy label is associated with an increased prevalence of infections by resistant organisms and longer hospitalisation. Clinician awareness of allergy assessment, referral indications, management of allergy and anaphylaxis is therefore vital but globally lacking. We aim to assess the knowledge of penicillin allergy, assessment and management in Western Australian health professionals.
An anonymous survey was distributed to pharmacists, nurses and physicians within Western Australian paediatric and adult Hospitals, Community and General Practice.
In total, 487/611 were completed and included in the statistical analysis. Only 62% (301/487) of respondents routinely assessed for patient medication allergies. Of those who assessed allergy, 9% (28/301) of respondents met the Australian standards for allergy assessment. Only 22% (106/487) of participants correctly cited all indications for management with adrenaline in anaphylaxis to antibiotics and 67% (197/292) of physicians rarely or never referred to an allergy service. Paediatric clinicians had an increased understanding of allergy assessment and anaphylaxis management. Recent penicillin allergy education within a 5-year period led to significant improvements in allergy knowledge.
Overall, knowledge, assessment and management of penicillin allergies among practitioners in Western Australia are currently inadequate in adults and paediatric clinicians to provide safe and effective clinical care. The implementation of a targeted education program for WA health professionals is urgently required and is expected to improve clinician knowledge and aid standardised penicillin assessment (de-labelling) practices.
青霉素过敏反应在成人和儿童所有报告的药物不良反应中占大多数。由于青霉素过敏标签而放弃一线抗生素治疗与耐药生物体感染的发生率增加和住院时间延长有关。因此，临床医生对过敏评估、转介指征、过敏和过敏反应管理的认识至关重要，但在全球范围内却缺乏这种认识。我们旨在评估西澳大利亚卫生专业人员对青霉素过敏、评估和管理的知识。
在西澳大利亚儿科和成人医院、社区和全科诊所向药剂师、护士和医生分发了匿名调查。
共完成并纳入统计分析的有 487/611 份。只有 62%（301/487）的受访者常规评估患者用药过敏情况。在评估过敏的受访者中，9%（28/301）符合澳大利亚过敏评估标准。只有 22%（106/487）的参与者正确列举了所有对青霉素类抗生素过敏反应管理使用肾上腺素的指征，67%（197/292）的医生很少或从不转介到过敏服务。儿科临床医生对过敏评估和过敏反应管理的理解有所提高。在过去 5 年内接受过青霉素过敏教育的医生，其过敏知识显著提高。
总体而言，西澳大利亚的医生对成人和儿科临床医生中青霉素过敏的了解、评估和管理目前不足，无法提供安全有效的临床护理。西澳大利亚卫生专业人员急需实施有针对性的教育计划，预计这将提高临床医生的知识水平，并有助于标准化青霉素评估（去标签）实践。
