Have you had your penicillin allergy checked lately?
A specialist clinic at Royal Brisbane and Women’s Hospital is changing the lives of patients diagnosed with penicillin allergies by re-testing their allergies to see if they still have a sensitivity.
Of all hospitalised patients at the Royal Brisbane and Women’s Hospital, 50 per cent will receive antibiotic treatment at some point in their stay. Of these 50 per cent, a little under half have an antibiotic allergy label (ALL) and approximately half of these are for a penicillin allergy.
Research has shown that patients with a penicillin allergy can report an increased length of stay, higher risk of surgical site infections and in rare cases, increased mortality. This is due to having to take broad-spectrum antibiotics rather than penicillin, a first line antibiotic. Using penicillin alternatives has also been linked to increased risk of the patient developing antibiotic resistance.
An appointment with the RBWH Infectious Diseases Allergy Clinic to test penicillin sensitivity could reveal they no longer need these ALLs.
Between 2018 and 2019, the clinic saw 120 patients. Of those patients, an incredible 92.5 per cent have been successfully de labelled as having a penicillin sensitivity.
The small, multi-disciplinary team at RBWH has made it their sole purpose to de-label patients of their penicillin allergy through safe, robust and repeatable testing. The team consists of Infectious Diseases Physician Dr Andrew Redmond, Penicillin De-Labelling Pharmacist Renee Palise and Registered Nurses Alice Young and Emily Hallas.
“Patients can be diagnosed with a penicillin allergy as children, however research has revealed that sometimes these people actually had a virus interacting with the penicillin or in the case of really old allergies from the 1950’s reacting to the additives that once were in penicillin, and not penicillin itself, however re-challenging allergies should always only be under taken by a specialist,” Renee said,
“While there are alternatives to penicillin antibiotics, they are generally not the best option.
“We realised there was an opportunity to retest these people and potentially change the effectiveness of their future healthcare, so the clinic was commenced in 2017.
“When patients are de-labelled for penicillin allergies it completely changes their treatment plan and has positive impacts for both the patient and the health service.”
The clinic is dependent on interhospital and GP referrals, so the team encourages people with penicillin allergies to see their GP and ask for a referral.
“Ideally, the clinic will connect with perioperative services in the future to target patients with a penicillin allergy before they have their surgery. If we can de-label their allergy prior to surgery, we can increase their overall healthcare experience by being able to prescribe penicillin,” said Renee.
The team would like to make a special mention to the Allergy Clinic at the Austin Hospital in Melbourne for passing on their learnings and providing training.
Anyone can see the Infectious Diseases Allergy Clinic; all you need is a referral from your GP or treating Doctor. Ask your doctor to send the referral to Infectious Diseases Dr Andrew Redman Allergy Clinic through CPI.