• Vanesa Anton-Vazquez, Francesca Ferretti, Deniz Kaya, Shashwat Mishra, Sven Kerneis, Charlotte Eden, Hong Doan, Hiu Fung Leung, Jeanelli Baltazar, Sarah Starkey, Juliet Uwagwu, Martino Dall'Antonia, and Jorge Cepeda.
• Medical Microbiology, Lewisham & Greenwich NHS Trust, London, UK. Electronic address: v.anton-vazquez@nhs.net.
• Clin Med (Lond). 2024 Feb 20; 24 (2): 100024100024.

BackgroundThe overdiagnosis of penicillin allergy and misclassification of non-truly allergic reactions is a growing public health problem, associated with the overuse of broad-spectrum and restricted antimicrobials. We aimed to evaluate the impact of penicillin allergy status on antimicrobial prescribing.MethodsA retrospective study of inpatients with a documented penicillin allergy receiving antimicrobials was conducted from 1 April to 1 July 2021. Antimicrobial prescribing and clinical characteristics were compared between patients with an active penicillin allergy label and those whose label was removed following antimicrobial stewardship team review. Antimicrobials were classified in two categories: i) 'Access' (recommended), ii) 'Watch and Reserve' (restricted) according to WHO AWaRe classification, a tool to guide appropriate antibiotic use.Results437 patients with a documented penicillin allergy receiving antimicrobials were included. 353 patients with an active penicillin allergy label, more frequently received antimicrobials from the 'Watch and Reserve list' (283;80% vs 30;37%; p<0.001). In contrast, 84 patients who were de-labelled received more often antimicrobials from the 'Access list' (53;63% vs 64;18%; p<0.001).ConclusionsPenicillin allergy reviews and de-labelling strategies may reduce the use of restricted antimicrobials under the 'Watch and Reserve list'. This practice should be encouraged and reinforced in all hospitals.Copyright © 2024. Published by Elsevier Ltd.

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