NACE PhD Scholar finds pharmacist-led inpatient penicillin allergy delabelling is effective and sustainable

Published

Wednesday, December 18, 2024 - 9:00 AM

Two million Australians self-report an allergy to penicillin, but most actually aren’t allergic.

These penicillin allergy labels can lead to inappropriate antibiotic prescribing in hospitalised patients. The problem is antimicrobial resistance (AMR) is on the rise, and antibiotic allergy labels and subsequent prescribing of inappropriate antibiotics are contributing factors.

Elise Mitri, National Allergy Centre of Excellence (NACE) drug allergy PhD Scholar, has investigated the long-term sustainability of a pharmacist-led antimicrobial stewardship (AMS) penicillin allergy delabelling ward round.

The prospective cohort study evaluated 477 adult inpatients with a penicillin allergy label at a Melbourne tertiary referral health service, for more than three years.

Elise’s findings, published by CMI Communications this week, found inpatient penicillin allergy delabelling was deemed effective, safe and sustainable in the pharmacist-led program.

Just over 95% low-risk inpatients were delabelled via direct oral penicillin challenge, with no serious adverse events. While 23.2% of all assessed patients had a non-immune mediated penicillin allergy label and were directly delabelled,

Elise, who is also a Drug Allergy Pharmacist at Austin Health, also showed that delabelling led to improved inpatient antimicrobial prescribing during the index admission and following discharge.

“Penicillin allergy in hospitalised patients is associated with negative patient and health service outcomes,” she said.

“To address the global burden of penicillin allergy in these patients, there is increasing adoption of low-risk penicillin allergy delabelling in the inpatient setting as a key antimicrobial stewardship intervention. This is increasingly being led by multi-disciplinary clinicians.”

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