Nav: Home

Recorded penicillin allergy linked to increased risk of 'superbug' infections

June 27, 2018

Risk largely due to use of 'broad spectrum' antibiotics as alternative to penicillin

Patients who have a penicillin allergy recorded in their medical records are at an increased risk of developing the drug resistant 'superbug' infection MRSA and healthcare-associated infection C difficile, finds a study published by The BMJ today.

The risk is largely due to the use of more 'broad spectrum' antibiotics as alternatives to penicillin, which may be fuelling the development of drug resistant bacteria.

The researchers argue that addressing penicillin allergies "may be an important public health strategy to reduce the incidence of MRSA and C difficile among patients with a penicillin allergy label."

Penicillin allergy is the most commonly documented drug allergy, reported by about 10% of patients. However, previous studies have shown that more than 90% of patients with listed penicillin allergies can be safely treated with penicillins.

To evaluate the public health consequences of a penicillin allergy label, researchers at Massachusetts General Hospital in Boston examined the relation between penicillin allergy and development of MRSA and C difficile.

Using data from the Health Improvement Network (THIN), an electronic medical record database of 11 million UK patients, they identified 64,141 adults with a documented penicillin allergy and 237,258 matched adults of similar age and sex, with recent penicillin exposure but without a penicillin allergy.

None of the participants had any history of MRSA and C difficile infection, and were followed up for an average of six years, during which time use of antibiotics and cases of doctor diagnosed MRSA and C difficile were recorded.

A total of 1,345 participants developed MRSA and 1,688 developed C. difficile over

the follow-up period.

After adjusting for several known risk factors, the researchers found that a penicillin allergy label was associated with a 69% increased risk of MRSA and a 26% increased risk of C difficile.

Once documented, a penicillin allergy was associated with increased use of alternative 'broad spectrum' antibiotics, which act against a wider range of bacteria.

The results show that increased use of broad spectrum antibiotics accounted for more than half (55%) of the increased MRSA risk and more than one third (35%) of the increased C difficile risk among patients with a listed penicillin allergy.

This is an observational study, so no firm conclusions can be drawn about cause and effect, and the researchers cannot rule out the possibility that other, unmeasured factors may have affected their results. However, they point out that this was a large, representative sample and the findings remained consistent after further analyses to test the strength of the results.

As such, they conclude that patients with a documented penicillin allergy "have an increased risk of new MRSA and C difficile that may be modifiable, to some degree, through changes in antibiotic prescribing."

As infections with resistant organisms increase, "systematic efforts to confirm or rule out the presence of true penicillin allergy may be an important public health strategy to reduce the incidence of MRSA and C. difficile," they add.
-end-


BMJ

Related Antibiotics Articles:

Antibiotics promote resistance on experimental croplands
Canadian researchers have generated both novel and existing antibiotic resistance mechanisms on experimental farmland, by exposing the soil to specific antibiotics.
Why antibiotics fail
UCSB biologists correct a flaw in the way bacterial susceptibility to these drugs is tested.
Fungi have enormous potential for new antibiotics
Fungi are a potential goldmine for the production of pharmaceuticals.
Antibiotics can boost bacterial reproduction
The growth of bacteria can be stimulated by antibiotics, scientists at the University of Exeter have discovered.
Last-line antibiotics are failing
The ECDC's latest data on antimicrobial resistance and consumption shows that in 2015, antibiotic resistance continued to increase for most bacteria and antibiotics under surveillance.
Two antibiotics fight bacteria differently than thought
Two widely prescribed antibiotics -- chloramphenicol and linezolid -- may fight bacteria in a different way from what scientists and doctors thought for years, University of Illinois at Chicago researchers have found.
Preserving the power of antibiotics
News release describes efforts to address inappropriate antibiotic prescribing in emergency departments and urgent-care centers nationwide, which a JAMA study published this past May found rates as high as 50 percent for acute respiratory infections in US emergency departments.
Antibiotics could be cut by up to one-third, say dairy farmers
Nine in 10 dairy farmers participating in a new survey from the Royal Association of British Dairy Farmers (RADBF) say that the farming industry must take a proactive lead in the battle against antibiotic resistance.
Antibiotics may be inappropriate for uncomplicated diverticulitis
Antibiotics are advised in most guidelines on diverticulitis, which arises when one or more small pouches in the digestive tract become inflamed or infected.
New book on Antibiotics and Antibiotic Resistance from CSHLPress
'Antibiotics and Antibiotic Resistance' from CSHLPress examines the major classes of antibiotics, together with their modes of action and mechanisms of resistance.

Related Antibiotics Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Bias And Perception
How does bias distort our thinking, our listening, our beliefs... and even our search results? How can we fight it? This hour, TED speakers explore ideas about the unconscious biases that shape us. Guests include writer and broadcaster Yassmin Abdel-Magied, climatologist J. Marshall Shepherd, journalist Andreas Ekström, and experimental psychologist Tony Salvador.
Now Playing: Science for the People

#513 Dinosaur Tails
This week: dinosaurs! We're discussing dinosaur tails, bipedalism, paleontology public outreach, dinosaur MOOCs, and other neat dinosaur related things with Dr. Scott Persons from the University of Alberta, who is also the author of the book "Dinosaurs of the Alberta Badlands".