Allergy labels have negative effects on antibiotic use, clinical outcomes
Click Here to Manage Email Alerts
Patients with antibiotic allergy labels received more broad-spectrum antibiotics, had at least one negative outcome and accrued higher drug- or hospital-related costs, according to the results of a systematic review.
“There is growing recognition that most patients with allergy labels are not truly allergic. These labels are often reported by the patient or labeled by a doctor after a minor reaction,” Adam L. Hersh, MD, PhD, and Nathan M. Krah, MD, PhD, pediatric infectious diseases physicians at the University of Utah, told Healio.
“A number of studies in recent years have compared clinical and other outcomes between patients with and without antibiotic allergies,” they said. “Many hospitals are investing in allergy de-labeling interventions. Our goal was to synthesize these studies, evaluate their quality and summarize this evidence base in a systematic review.”
Hersh, Krah and colleagues performed a systematic review to identify studies reporting outcomes in patients with antibiotic allergy labels compared with nonallergic equivalents. According to the study, two reviewers independently screened studies from PubMed, EMBASE, Cochrane CENTRAL, EBSCO, Cochrane Database of Abstracts of Reviews of Effects and Web of Science, for inclusion and abstracted data. Outcomes of the 41 included studies were antibiotic use, clinical outcomes and economic outcomes.
Among the 34 studies examining antibiotic exposure, 32 (94%) demonstrated that patients with antibiotic allergy labels received more broad-spectrum antibiotics. Additionally, among 31 studies that examined clinical outcomes including hospitalization, ICU admission, hospital readmission, multidrug-resistant or opportunistic infection, or mortality, 27 (87%) found that allergy-labeled patients had at least one negative outcome. The review also found that of the nine studies examining health care costs, seven (78%) found that allergy-labeled patients incurred significantly higher drug or hospital-related costs, the researchers reported.
“It is important for clinicians to be aware of the harms associated with antibiotic allergies,” Hersh and Krah said. “Clinicians should not assume antibiotic allergies are always accurate and can make efforts to clarify the allergy history. Interventions that de-label allergies through history taking and oral or skin test challenges will benefit patients.”
Collapse
Read more about
Click Here to Manage Email Alerts