Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 1:4:23.
doi: 10.1186/s13756-015-0063-6. eCollection 2015.

The impact of antimicrobial allergy labels on antimicrobial usage in cancer patients

Jason A Trubiano  1 , Vivian K Leung  2 , Man Y Chu  2 , Leon J Worth  2 , Monica A Slavin  3 , Karin A Thursky  3
Affiliations

The impact of antimicrobial allergy labels on antimicrobial usage in cancer patients

Jason A Trubiano et al. Antimicrob Resist Infect Control. .

Abstract

Background: Antibiotic allergy labels are associated with sub-optimal prescribing patterns and poorer clinical outcomes in non-cancer populations, but the effect of labelling on antimicrobial usage in patients with cancer is unknown.

Findings: A retrospective review of hospitalized patients admitted to the Peter MacCallum Cancer Centre (2010-2012) identified 23 % of cancer patients (n = 198) with an antimicrobial allergy label (AA). Comparison of those with an antimicrobial allergy label to those without demonstrated increased antibiotic use per admission (3 vs. 2, p = 0.01), increased fluoroquinolone use (11 % vs. 6 %, p < 0.05), increased antibiotic course duration (15 vs. 13 days, p = 0.09), higher readmission rates (53 % vs. 28 %, p < 0.001) and poorer concordance with prescribing guidelines (47 % vs. 91 %, p < 0.001). Patients in the AA group on multivariate analysis had a higher number of antibiotics employed, longer duration of antibiotic therapy and higher rate of readmission.

Conclusions: Antimicrobial usage, including the use of restricted antibiotics, is higher in patients with cancer. Antibiotic de-labelling strategies in cancer patients must be evaluated to aid antimicrobial stewardship initiatives.

Keywords: Antibiotic allergy; Antimicrobial resistance; Cancer; Stewardship.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The percentage of total antibiotic courses (all admissions during study period) per antimicrobial class for antimicrobial allergy (AA) and no antimicrobial allergy (NAA) groups. Abbreviations: AA, antimicrobial allergy group; NAA, no antimicrobial allergy group. *P value < 0.05
See this image and copyright information in PMC

References

    1. Blanca M, Romano A, Torres MJ, Férnandez J, Mayorga C, Rodriguez J, et al. Update on the evaluation of hypersensitivity reactions to beta lactams. Allergy. 2009;64:183–193. doi: 10.1111/j.1398-9995.2008.01924.x. - DOI - PubMed
    1. Romano A, Warrington R. Antibiotic allergy. Immunol Allergy Clin North Am. 2014;34(3):489–506. doi: 10.1016/j.iac.2014.03.003. - DOI - PubMed
    1. Trubiano J, Phillips E. Antimicrobial stewardship’s new weapon? A review of antibiotic allergy and pathways to ‘de-labeling’. Curr Opin Infect Dis. 2013;26(6):526–37. doi: 10.1097/QCO.0000000000000006. - DOI - PMC - PubMed
    1. Charneski L, Deshpande G, Smith SW. Impact of an antimicrobial allergy label in the medical record on clinical outcomes in hospitalized patients. Pharmacotherapy. 2011;31(8):742–7. doi: 10.1592/phco.31.8.742. - DOI - PubMed
    1. Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin “allergy” in hospitalized patients: A cohort study. J Allergy Clin Immunol. 2014;133(3):790–6. doi: 10.1016/j.jaci.2013.09.021. - DOI - PubMed

LinkOut - more resources