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A study of long-term care (LTC) facilities in Massachusetts found that residents with a proven penicillin allergy were 95% less likely to receive beta-lactam antibiotics, researchers say. reported yesterday in the journal Antiological Stewardship & Healthcare Epidemiology.
For the study, researchers from Tufts University and the Massachusetts Department of Public Health analyzed data on antibiotic prescribing and penicillin allergies at 20 LTC facilities across the state. The purpose of this study was to determine the impact of documented penicillin allergy on beta-lactam antibiotic prescribing patterns in LTC facilities where an estimated 50% to 75% of residents receive antibiotics at least annually. It was to do. Previous research has shown that penicillin allergy labels are often inaccurate, which can result in the selection of broader-spectrum antibiotics, which contributes to antimicrobial resistance and increases the risk of side effects. It has been shown that
“Inaccurate penicillin allergy labeling poses a significant health threat to this vulnerable population, as older adults have higher mortality rates from multidrug-resistant infections and side effects from broad-spectrum antibiotics,” study authors wrote. are writing.
Efforts to remove the labeling of penicillin allergy required for LTC
Of the 2,345 nursing home residents, 449 (19.1%) received antibiotics, and of those who received antibiotics, 156 (34.7%) had a documented penicillin allergy. Ta. The main indications for antibiotic prescription were urinary tract infections (UTIs) (45.4%), respiratory tract infections (RTIs) (29.2%), and skin and soft tissue infections (SSTIs) (18.5%). Beta-lactams accounted for 45.5% of all antibiotic prescriptions.
Inaccurate penicillin allergy labeling poses a serious threat to the health of this vulnerable population, as older adults have higher mortality rates from multidrug-resistant infections and side effects from broad-spectrum antibiotics.
Multivariate regression analysis revealed that residents with proven penicillin allergy were significantly less likely to receive beta-lactam antibiotics for all infections (adjusted odds ratio ( aOR), 0.05; 95% confidence interval (CI), 0.03 to 0.09). aOR, 0.03; 95% CI, 0.01 to 0.08), RTI (aOR, 0.05; 95% CI, 0.02 to 0.13), and SSTI (aOR, 0.11; 95% CI 0.03 to 0.38).
The authors state that this finding highlights the need to improve assessment and delabeling strategies for penicillin allergy in the LTC setting.
