Patients with penicillin allergy often treated with less effective antibiotics

People who have a penicillin allergy are more likely to receive “inferior” antibiotics when hospitalized, potentially causing more side effects, according to data published in JAMA Internal Medicine.

In this study, the medical records of 10,992 hospitalized patients who received antibiotics were reviewed. Nearly 16% of these patients had a documented penicillin allergy, resulting in increased odds of receiving beta-lactam antibiotic as an alternative and lower odds of receiving a narrow-spectrum beta-lactam antibiotic.

Patients with a penicillin allergy were also found to have 18-fold increased odds aztreonam use.

Because “Allergy assessment with or without diagnostic testing disproves more than 90% of documented penicillin allergies,” the researchers wrote, patients in this study may not have received the best treatment. Hospitals should consider inpatient penicillin allergy interventions for patients with planned surgical procedures.

Reference

Blumenthal KG, Kuper K, Schulz LT, et al. Association between penicillin allergy documentation and antibiotic use. JAMA Intern Med. Published online June 29, 2020. doi:10.1001/jamainternmed.2020.2227