A research of long-term care (LTC) services in Massachusetts discovered that residents with a documented penicillin allergy have been 95% much less more likely to obtain beta-lactam antibiotics, researchers reported yesterday in Antimicrobial Stewardship & Healthcare Epidemiology.
For the research, researchers from Tufts College and the Massachusetts Division of Public Well being analyzed knowledge on antibiotic prescriptions and penicillin allergic reactions at 20 LTC services throughout the state. The intention of the research was to measure the influence of documented penicillin allergic reactions on the prescribing patterns of beta-lactam antibiotics in LTC services, the place an estimated 50% to 75% of residents obtain at the least on antibiotic yearly. Earlier analysis has proven that penicillin allergy labels are regularly inaccurate and can lead to the collection of broader-spectrum antibiotics, which contribute to antimicrobial resistance and have an elevated threat of unintended effects.
“Inaccurate penicillin allergy labeling poses a essential well being menace on this weak inhabitants as a result of older people are extra prone to mortality from multidrug-resistant infections and hostile results from broad-spectrum antibiotics,” the research authors wrote.
Penicillin allergy delabeling efforts wanted in LTCs
Amongst 2,345 LTC residents, 449 (19.1%) obtained an antibiotic, and 156 of the antibiotic recipients (34.7%) had a documented penicillin allergy. The first indications for antibiotic prescriptions have been urinary tract infections (UTIs) (45.4%), respiratory tract infections (RTIs) (29.2%), and pores and skin and soft-tissue infections (SSTIs) (18.5%). Beta-lactams accounted for 45.5% of all antibiotic prescriptions.
Inaccurate penicillin allergy labeling poses a essential well being menace on this weak inhabitants as a result of older people are extra prone to mortality from multidrug-resistant infections and hostile results from broad-spectrum antibiotics.
Multivariable regression evaluation revealed that residents with a documented penicillin allergy have been considerably much less more likely to be receiving beta-lactam antibiotics for all infections (adjusted odds ratio [aOR]0.05; 95% confidence interval [CI]0.03 to 0.09), UTIs (aOR, 0.03; 95% CI, 0.01 to 0.08), RTIs (aOR, 0.05; 95% CI, 0.02 to 0.13), and SSTIs (aOR, 0.11; 95% CI 0.03 to 0.38).
The authors say the findings underscore the necessity to enhance penicillin allergy assessments and delabeling methods in LTC settings.
