What’s in the News: Reported Penicillin Allergies and Antibiotic Prescribing

Among pediatric inpatients at a large children’s hospital, the rate of reported penicillin allergies was nearly 9%, according to research presented at a recent meeting. The study also found increased use of 4th generation cephalosporins, lincosamides, and sulfonamides in patients with a penicillin allergy label who were prescribed antibiotics compared to patients without a reported allergy. Approximately 13,000 children who were admitted to the facility in 2019 met the study’s inclusion criteria, and nearly 7,000 inpatients received antibiotics during their hospitalization and were included in the data analysis. The findings, which add to the limited literature on the impact of penicillin allergy labels in the pediatric population, were presented at the virtual meeting of the Society of Hospital Medicine.

“The retrospective chart review by Dyer et. al highlights the important aspect of variance of practice and potential risk posed to pediatric patients with penicillin antibiotic allergy labels,” said Amol Purandare, MD, of Children’s Mercy Kansas City and an assistant professor of pediatrics at the University of Missouri-Kansas City School of Medicine who was not involved with the research. “As providers we need to be cognizant of how we characterize reactions and understand, as the study indicates, allergy labels will stay with patients into adolescence and adulthood while likely placing them on unnecessary broader spectrum therapy. It is a good example of why there needs to be a continuous push in educating providers on clarifying allergy labels, establishing allergy testing and challenges, and using narrow-spectrum cephalosporins with different side chains should testing be unable to be performed.”

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