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Title: Burden of antibiotic allergy labels in Australian aged care residents: Findings from a national point-prevalence survey.
Austin Authors: Travis, Laura;Worth, Leon J;Trubiano, Jason ;Thursky, Karin;Bennett, Noleen
Affiliation: Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
National Centre for Antimicrobial Stewardship, Melbourne, Australia
Department of Nursing, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, Melbourne, Australia
Department of Medicine, University of Melbourne, Melbourne, Australia
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
National Centre for Antimicrobial Stewardship, Melbourne, Australia
Issue Date: Jun-2020
Date: 2020-03-19
Publication information: Infection Control and Hospital Epidemiology 2020; 41(6): 641-644
Abstract: To determine the prevalence of antibiotic allergy labels (AALs) in Australian aged care residents and to describe the impact of labels on antibiotic prescribing practices. Point-prevalence survey. Australian residential aged care facilities. We surveyed 1,489 residents in 407 aged care facilities. Standardized data were collected on a single day between June 1 and August 31, 2018, for residents prescribed an antibiotic. An AAL was reported if it was documented in the resident's health record. Resident-level data were used to calculate overall prevalence, and antibiotic-level data were used to report relative frequency of AALs for individual antibiotics and classes. Among 1,489 residents, 356 (24%) had 1 or more documented AALs. The AALs for penicillin (28.3%), amoxicillin or amoxicillin/clavulanic acid (10.5%), cefalexin (7.2%), and trimethoprim (7.0%) were most commonly reported. The presence of an AAL was associated with significantly less prescribing of penicillins (OR, 0.43; 95% CI, 0.31-0.62; P < .001) and significantly more prescribing of lincosamides (OR, 4.81; P < .001), macrolides (OR, 2.03; P = .007), and tetracyclines (OR, 1.54; P = .033). Of residents with AALs, 7 residents (1.9%) were prescribed an antibiotic that was listed on the allergy section of their health record. A high prevalence of AALs was observed among residents of Australian aged care facilities, comparable to the prevalence of AALs in high-risk hospitalized patients. Significant increases in prescribing of lincosamide, macrolide, and tetracycline agents poses a potential risk to aged populations, and future studies must evaluate the benefits of AAL delabelling programs tailored for aged care settings.
DOI: 10.1017/ice.2020.53
ORCID: 0000-0002-1321-7271
Journal: Infection control and hospital epidemiology
PubMed URL: 32188526
Type: Journal Article
Appears in Collections:Journal articles

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