RESEARCHERS from Monash University's Faculty of Pharmacy and Pharmaceutical Sciences (FPPS) have successfully piloted an algorithm to identify incorrect penicillin allergy labels and educate patients presenting to community pharmacies.
Patients may be labelled as allergic to penicillin because they have experienced common side effects such as nausea or headaches, as opposed to a true immune-mediated penicillin allergy, which impacts less than one percent of the population.
These incorrect penicillin labels are known as 'Type A' (a non true allergy) or 'non-immune mediated' penicillin reactions.
A patient labelled as penicillin-allergic may be prescribed a broader-spectrum antibiotic instead, which has several drawbacks, including contributing to antimicrobial resistance (AMR).
The goal behind identifying and de-labelling incorrect penicillin allergy labels is to reduce inappropriate prescribing of antibiotics to improve patient safety and help fight against AMR, which is largely driven by the overuse and misuse of antibiotics.
The research took place across five pharmacies in metropolitan Victoria over seven weeks in 2024.
Of the almost 19,000 patients who presented to the pharmacies during this time, 163 had a penicillin allergy label, of which 18.4% were identified as having a Type A or non-immune mediated penicillin reaction history.
More than three-quarters (77%) of those with a Type A or non-immune mediated allergy label were receptive to education and de-labelling, while 23% were hesitant or non-receptive for various reasons, including disbelief that their allergy label is incorrect.
Dr Angelina Lim from the FPPS said teaching pharmacists to de-label incorrect allergies in the community is an important part of antimicrobial stewardship.
"As medicine experts and frontline healthcare workers who are readily accessible to the community, we believe community pharmacists are well placed to provide penicillin allergy de-labelling support that will improve antibiotic prescribing for patients," Dr Lim said.
"We recognise that community pharmacies are busy and having a simple algorithm to follow may help support them make interventions day to day," she added.
The algorithm comprises integration of adult and paediatric antibiotic allergy assessment tools, with all patients asked a series of validated antibiotic allergy questions by students trained to implement the algorithm.
The authors concluded the algorithm can support everyday community pharmacy practice and reduce the risk of incorrect antibiotic allergy labels in the community.
Read the study HERE. KB
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