The majority of Australians who report a penicillin allergy are not truly allergic, prompting the peak body for immunologists to change its guidelines in a bid to reduce hospitals stays and tackle antimicrobial resistance.
asserted
who → report → resistance
Penicillin, one of the most commonly prescribed antibiotics in Australia, was thought to cause allergies in 10% of Australians, or about 2.8 million people.
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Penicillin → prescribe → Australians
But the latest evidence shows up to 90% of those reporting a penicillin allergy do not have one.
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% → show → one
The changes to the Australasian Society of Clinical Immunology and Allergy guidelines, which have been published in the Journal of Allergy and Clinical Immunology, give the first peer-reviewed and updated advice to GPs and other health professionals about how to diagnose and manage the allergy, and when to refer to a specialist.
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which → publish → specialist
Prof Michaela Lucas, a clinical immunologist, said misdiagnosis occurs for a number of reasons, with people sometimes experiencing a rash or nausea after taking penicillin and assuming it’s an allergy, or doctors wanting to be cautious and recording side-effects as allergies.
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doctors → say → allergies
Other people were told by a parent that they suffered a reaction when they were a child and carry that diagnosis through to adulthood without questioning it, she said, while some side-effects may also be due to the illness itself and not the medicine.
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effects → tell → illness
Penicillin is an important antibiotic option, as it treats common infections, said Lucas, a professor at the University of Western Australia’s medical school.
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Lucas → treat → school
“It is also what is known as a narrow spectrum antibiotic, which means it is targeted at the bug specifically causing the infection,” she said.
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she → know → infection
“Once you have to avoid narrow classes of drugs, you have to use broader spectrum antibiotics which have a bigger impact of your gut microbiome as they are associated with also killing good bacteria and allowing superbugs to come in and take residency.
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superbugs → have → residency
“Antimicrobial resistance matters beyond the individual patient, because resistant bacteria can spread between people and through communities,” Lucas said.
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Lucas → matter → communities
“If someone develops a serious infection that is resistant to several antibiotics, doctors can be left with very limited treatment options.”
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doctors → develop → options
Dr Nick Cooling, the chair of the Royal Australian College of General Practitioners’ allergy special interest group, said the guidelines were based on the latest evidence, and a consensus report from a range of medical specialities.
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guidelines → say → specialities
He hopes the guidance will cut health costs in the community and ease the burden on immunologists.
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guidance → hop → immunologists
“We know that people who have a penicillin allergy label go to hospital more,” he said.
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he → know → hospital
“They spend longer in hospital, and they also cost the system more.”
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they → spend → more
This is because of more treatments needing to be trialled, side-effects from those treatments, and delays in finding alternative treatments.
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This → need → treatments
“The ability to clarify that with these patients will reduce hospital costs but also the whole health system cost,” he said.
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he → clarify → costs
“We need all health professionals to be involved in this because if we’re going to de-label some 2.8 million people in Australia, you can’t just rely on the 300 immunologists to do that.”
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you → need → that
Cooling urged affected patients to raise the question of a penicillin allergy with their GP, and with cases where the potential risk of harm is low, doctors could give their patient penicillin and monitor for symptoms.
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doctors → cool → symptoms
But he warned: “No one should try taking penicillin themselves to find out whether they are allergic.
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they → warn → penicillin
Antibiotics should only be taken when prescribed for the individual taking them.”
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Antibiotics → take → them
She welcomes the changes, with her 70-year-old mother and 12-year-old daughter both diagnosed.
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mother → welcome → changes
Prescino worries that if her mother were to get an infection, she could miss out on the benefits of penicillin.
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she → worry → penicillin
She plans to see a doctor and to get her family reassessed.
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family → plan → doctor
“Because if she doesn’t have the penicillin allergy, then we wouldn’t have to withhold medicine … that could help her,” Prescino said.
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Prescino → have → her
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