PDF 182 KB
To document a suspected reaction to an antimicrobial drug
Penicillin and other antibiotic allergies are commonly reported in a patient’s history, but the nature of the reaction is often unknown or poorly documented.
Assessment of a patient’s true allergy status, and antibiotic allergy de-labelling where appropriate, is an important antimicrobial stewardship (AMS) activity and leads to improved patient outcomes.1
In South Australia, 9.3% of the population have reported they are allergic to penicillin.2 The majority of these (90%) who undergo formal testing are not truly penicillin allergic and would tolerate penicillins without reaction3, and approximately two thirds of them are candidates for low risk de-labelling.
Patients who are labelled as “penicillin allergic” are more likely to be treated with potentially less effective or broader-spectrum antibiotics, increasing the risk of adverse events, treatment failure and antibiotic resistance. They also have longer lengths of hospital stay and are at higher risk of multi-drug resistant organisms, readmission to hospital and treatment related adverse events.4
The presence of a MedicAlert® bracelet should not exclude a patient from consideration for de-labelling. Many patients are inaccurately labelled with a penicillin allergy. Nevertheless it is essential that those with a true allergy are accurately and effectively labelled to avoid serious adverse outcomes.
It is essential that antibiotic allergies are accurately recorded in electronic health records or patient medical notes. Accurate documentation helps improve antibiotic choices in patients with allergies.
Use an Adverse Drug Reaction Report (PDF 183KB) form to document the reaction. The report can be used as a template to upload details of the reaction into the patient’s Sunrise® electronic medical record, My Health Record, or kept as a hard copy in the patient medical notes.
Remember, the more information recorded about the reaction, the better the future care of the patient will be.
Determine the nature and severity of any previous reaction – check the medical notes for an Adverse Drug Reaction Report form (PDF 183KB). Determine how the previous reaction was managed, how quickly did the reaction occur after starting the drug, how long ago it happened and whether the patient has been prescribed the same or similar antibiotics since.
The National Antibiotic Allergy Network (NAAN) has developed these patient information leaflets:
Patients can also use this Antibiotic Allergy Alert Card.
NAAN has developed guidance for clinicians on antibiotic allergy assessment and management of an oral antibiotic challenge in patients who have an antibiotic allergy.
For more information on allergies specific to agents in the penicillin and/or cephalosporin antibiotic classes, including practical advice on assessment and management, visit the Penicillin and cephalosporin allergies page.
Information on other antimicrobial allergies (for example, sulfonamide or carbapenum allergies) can be viewed on the Other Antimicrobial Allergies page.