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Antibiotic allergy labels in children are associated with adverse clinical outcomes

Lucas, M., Arnold, A., Sommerfield, A., Trevenen, M., Braconnier, L., Schilling, A., Abass, F., Slevin, L., Knezevic, B., Blyth, C., Murray, K., von Ungern-Sternberg, B. and Rueter, K. (2018) Antibiotic allergy labels in children are associated with adverse clinical outcomes. The Journal of Allergy and Clinical Immunology: In Practice, 7 (3). pp. 975-982.

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Self-reported antibiotic allergies are common among hospitalised adults and children. There is a paucity of studies investigating the impact of an antibiotic allergy label in childhood.

To investigate the impact of antibiotic allergy labelling on clinical outcomes in children.

Retrospective study conducted in a major paediatric tertiary hospital, to capture 1672 inpatient admissions in April 2014 and April 2015. Data, collected by chart review, included documented antibiotic allergy labels, antibiotic prescriptions, admitting specialty, hospital length of stay, and hospital readmissions.

Of the 1672 paediatric patients surveyed, 58.1% were male and 44.8% were prescribed antibiotics. Antibiotic allergy labels were recorded in 5.3% of patients; the majority were beta-lactam labels (85%), mostly to unspecified penicillins. There was an increasing incidence of antibiotic allergy label with age, which was statistically significant (P<0.001); no gender effect was seen. Patients with antibiotic allergy labels received more macrolide (p=0.045), quinolones (P=0.01), lincosamide antibiotics (P<0.001) as well as metronidazole (p=0.009) than patients without an antibiotic allergy label. After adjusting for patient age, sex, principal diagnosis and admitting specialty, children with any antibiotic or beta-lactam allergy label had longer hospital lengths of stay (OR 1.62, 95% CI 1.05-2.50, P=0.03; with mean length of stay of 3.8 days for those without a label and 5.2 days for those with a beta-lactam allergy label).

This is the first study demonstrating the negative impact of antibiotic allergy labels on clinical outcomes in children, as evidenced by significant alternate antibiotic use and longer hospital lengths of stay.

Item Type: Journal Article
Murdoch Affiliation(s): Institute for Immunology and Infectious Diseases
Publisher: Elsevier
Copyright: © 2018 Published by Elsevier Inc.
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