Penicillin allergy in patients being treated for pneumonia-making a case for quality improvement project (2019)

Type of publication:
Conference abstract

Author(s):
*Mahendiran T.; *Omar M.K.; *Moudgil H.; *Crawford E.; *Srinivasan K.; *Makan A.; *Ahmad N.

Citation:
Thorax; Dec 2019; vol. 74 (Suppl. 2)

Abstract:
Background Penicillin allergy is reported by approximately 10% of the UK population, however only 20% of these actually have a true allergy.1 In addition, a documented penicillin ‘allergy’ may be associated with a prolonged length of stay (LOS) related to longer duration of treatment, complications and adverse effects related to second-line antibiotic use.2 Aim Our primary aim was to establish a documentation of the type of allergy to Penicillin within a cohort of patients presenting to our hospitals with community acquired pneumonia. Secondary aim was to compare the length of hospital stay, readmission within 30 days, complications and 30-day mortality between patients with and without penicillin allergy. Method We obtained data on all hospital admissions with a coded diagnosis of Pneumonia for the period covering October-December 2017. We divided this cohort into those with and without penicillin allergy; allergy information being obtained from discharge summaries and local pharmacy information system. Microsoft Excel and http://vassarstats.net/was used for statistical evaluation. Results 308 admissions were coded as pneumonia in this period. We excluded 77 admissions due to lack of data. Of the remaining, 187 had no penicillin allergy and 44 were allergic to penicillin. This gives a prevalence of 19% (44/231), which is higher than the reported prevalence above, of which 95% (42/44) did not have the type of allergy mentioned. Allergic group was older with a mean age (SD) 75 (15) v 72 (16) years [p value=0.0005], had more females 69% (31/44) v 41% (77/187) [p value=0.02], same LOS 6 days [p value=0.39], more readmissions 20% (9/44) v 16% (29/187) [p value=0.56], no greater complications 20% (9/44) v 20% (37/187) [p value=0.92] and a higher unadjusted overall mortality 14% (6/44) v 10% (18/187) (p value=0.61) Conclusion Data shows: 1. Poor documentation of the type of allergy to Penicillin. This needs a Quality improvement project as it is likely that most patients may not have a true allergy as shown in previous studies.1 2. Allergic group were older, with more females but the other variables were not statistically significant. We would recommend further research in this area to inform future practice.

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