Penicillin allergy label in the electronic medical record: an opportunity to avoid the inappropriate use of antibiotics

Abstract

Background: Between 8-25% of the population is labeled as allergic to penicillin, but less than 1% are truly allergic. Alternative antibiotics often have higher therapeutic failure rates, relapses, adverse effects, and induce antimicrobial resistance. De-labeling individuals who believe they are allergic but are not is one of the pillars in combating multi-resistance. Aim: To describe the prevalence of penicillin allergy labeling in the population of the Health Plan of the Hospital Italiano de Buenos Aires (HIBA) in May 2022, and to categorize the risk using the PEN-FAST scale. Additionally, to describe associated allergies and the dispensing of beta-lactam antibiotics. Method: A cross-sectional observational descriptive study was conducted in the population of the Health Plan (HP) of HIBA. All patients labeled as allergic were contacted via email, and those who agreed to participate underwent a telephone interview. Results: About 2.9% of the members are labeled as allergic to penicillin. 217 individuals consented and participated. Of these, 51% had already consulted a specialist. Among those who had never undergone specific tests, 43% were found to have low or very low-risk allergies. 93% of the allergic events occurred more than 5 years ago, and 62% did not experience anaphylaxis. Half of the respondents reported requiring treatment, but 3 out of 4 did not know or remember what treatment they received. Conclusion: Two out of 5 allergy sufferers in the PS had a low or very low risk allergy and probably not really. We must continue to correct mislabels.