Description and accuracy of antibiotic allergy labels at North Shore Hospital.

ABSTRACT

AIMS: Antibiotic allergy labels are common and associated with adverse care. Most people with an antibiotic allergy label are found to be non-allergic on investigation. The aims of this study were to evaluate the burden and accuracy of antibiotic allergy labels at North Shore Hospital and to identify and assess beta-lactam specific allergies, and the potential impact of an inpatient antibiotic allergy service. METHODS: An evaluation of documented inpatient adverse drug reaction (ADR) labels. Structured assessment of beta-lactam allergies was undertaken using the Austin Health tool. RESULTS: Three hundred and seven patients were reviewed; 78 patients had an antibiotic allergy label, with 102 individual labels. Fifty-five of these 78 patients underwent structured assessment. Forty-four patients had a beta-lactam-specific antibiotic allergy label. Using the Austin Health tool, 9/44 (20%) of beta-lactam-specific allergy labels could have been removed following a history alone and a further 16/44 (36%) would have been appropriate for direct oral challenge. Antibiotic allergy label accuracy was 64% for beta-lactam antibiotics, and 69% for non-beta-lactams. CONCLUSIONS: The prevalence of antibiotic specific allergies in our centre was similar to New Zealand and Australian statistics.1,2 Our study showed that a significant proportion of inpatients with a beta-lactam-specific allergy could be de-labelled on history or with a single dose challenge.