Many Cases of 'Penicillin Allergy' Might Be Mistaken

WEDNESDAY, July 8, 2020 (HealthDay News) -- Penicillin allergy is often unconfirmed in hospital patients, meaning many unnecessarily receive other antibiotics that may be less effective and even harmful, a new study finds.

The researchers analyzed records of nearly 11,000 patients at 106 U.S. hospitals and found that 16% of those with a self-reported penicillin allergy were twice as likely to be prescribed alternative antibiotics.

But the substitutions were probably unnecessary, according to a study published recently in JAMA Internal Medicine, because more than nine out of 10 reported penicillin allergies have not been confirmed.

"Too often clinicians are making inferior antibiotic decisions based on unverified penicillin allergy histories that may date back to a patient's childhood and are no longer valid," said lead author Dr. Kimberly Blumenthal, of the division of rheumatology, allergy and immunology at Massachusetts General Hospital in Boston.

"As a result, patients are often prescribed antibiotics other than penicillins and cephalosporins -- some of our core infection fighters -- that may increase the risk of adverse side effects and antibiotic resistance," she explained.

This pattern could be changed if doctors did "a little more testing" or took the time to ask patients about a reported penicillin allergy, rather than taking the penicillin allergy label at face value, she said.

About half of hospitalized patients receive antibiotics to treat or prevent bacterial infections, and more than 10% have a penicillin allergy documented in their medical records.

Hospitals need to do a better job of risk detection, Blumenthal said. But she noted that while there is a diagnostic test to detect penicillin allergy, less than half of hospitals have access to it.

"Hospitals should clearly be treating patients with the most targeted and effective antibiotic for their infection, rather than being influenced by a penicillin reaction years earlier that might have been nothing more than itching or a headache," she said in a hospital news release. "That will require hospitals to become much more vigilant and proactive in penicillin allergy assessment as part of their inpatient antibiotic stewardship programs."

More information

There's more on penicillin allergy at the American Academy of Allergy, Asthma and Immunology.

SOURCE: Massachusetts General Hospital, news release, June 30, 2020

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