Penicillin allergy increases risk for use of less-effective antibiotics

A new study finds that 64 percent of patients with a penicillin allergy receive a less-effective drug instead. Photo by John Angelillo/UPI
A new study finds that 64 percent of patients with a penicillin allergy receive a less-effective drug instead. Photo by John Angelillo/UPI | License Photo

June 29 (UPI) -- People allergic to penicillin are nearly twice as likely to receive a less effective antibiotic during hospitalization, with more side effects, those who are not allergic to the drug, an analysis published Monday by JAMA Internal Medicine found.

In all, 16% of hospitalized patients have a penicillin allergy, with 45 percent of allergic reactions to the drug involving hives or rash, the researchers said.


Most of those allergic to the antibiotic, 64 percent, received a "broad-spectrum" beta-lactam -- a class of drugs that acts on a wide range of disease-causing bacteria, they found.

Use of broad-spectrum antibiotics has been linked with development of resistant bacteria, or those that don't respond to drug treatment.

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"I suggest patients discuss their drug allergies with their primary care provider," co-author Dr. Kimberly Blumenthal, quality and safety officer for allergy at Massachusetts General Hospital, told UPI.

"It may be possible to clarify the allergies without testing, or testing -- such as penicillin skin testing -- may be recommended," she said.

Roughly half of all hospitalized patients receive an antibiotic, Blumenthal said. Historically, research has suggested that roughly one in 10 people have a penicillin allergy listed in their medical records.

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However, testing "disproves" up to 90 percent of these cases, Blumenthal and her colleagues said.

For their study, the researchers reviewed data on nearly 11,000 patients from the Irving, Texas-based Acute Care Hospital Groups, which are part of Vizient Inc.

Among participants, 48 percent of patients without a penicillin allergy received a broad-spectrum beta-lactam antibiotic, they said. Just 13 percent of patients with a penicillin allergy received a narrow-spectrum -- or more targeted -- beta-lactam, compared to 30 percent of non-allergic patients, the researchers found.

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Narrow-spectrum beta-lactams are less likely to cause resistance, they said.

In addition, those with a penicillin allergy were more than twice as likely to receive a broad-spectrum antibiotic to treat a urinary tract infection and more than seven times as likely to receive these drugs for infection prevention before surgery, the researchers said.

"Broader-spectrum [antibiotics are] associated with treatment failures and adverse reactions," Blumenthal said. "I would encourage patients with a penicillin allergy on their medical record to seek out confirmatory testing ... before being sick or hospitalized."

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