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Enhancing antibiotic stewardship by tackling "spurious" penicillin allergy.

Krishna, M T and Huissoon, A P and Li, M and Richter, A and Pillay, D G and Sambanthan, D and Raman, S C and Nasser, S and Misbah, S A (2017) Enhancing antibiotic stewardship by tackling "spurious" penicillin allergy. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 47 (11). pp. 1362-1373. ISSN 1365-2222. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs

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Official URL: http://onlinelibrary.wiley.com/doi/10.1111/cea.130...

Abstract

Approximately 90-99% of patients with a label of penicillin allergy (PenA) are not allergic when comprehensively investigated. An inaccurate label of PenA has major public health implications-longer hospital stay, more frequent hospital admissions, greater use of fluoroquinolones, glycopeptides, cephalosporins and other expensive antibiotics resulting in significantly higher costs to the health service and predisposing to Clostridium difficile, methicillin-resistant Staphylococcus aureus infections and vancomycin-resistant enterococcus. We describe lessons learnt from recent studies regarding possible reasons contributing to an inaccurate label of PenA as well as propose a concerted multidisciplinary approach to address this important public health problem. Given the unmet need for allergy services in the UK and several other countries and knowledge gaps regarding PenA amongst healthcare professionals, we describe the potential role for a computerized clinical decision support system to enable non-specialists rapidly identify and de-label "low-risk" hospitalized patients with a label of PenA thereby obviating the need for allergy tests. This approach however needs rigorous evaluation for feasibility, safety, patient and physician acceptability, cost-effectiveness and its compatibility with information technology systems currently employed in the health service.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
Subjects: WD Diseases and disorders of systemic, metabolic or environmental origin > WD300 Hypersensitivity. Allergy
Divisions: Clinical Support > Pathology
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 22 Nov 2017 15:48
Last Modified: 22 Nov 2017 15:48
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1482

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