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Study reveals level of incorrect allergy labels which help to drive antibiotic resistance

A team at a North East NHS trust has launched a project to tackle the issues caused by patients incorrectly being labelled as allergic to certain medicines.

The Catalyst (Challenging Antibiotic Allergy Status) process has been developed by a team at Northumbria Healthcare NHS Foundation Trust to challenge dubious penicillin allergies in a bid to help tackle a growing concern over antibiotic use.

Currently, around 10-20% of patients in UK hospitals are reported to have an allergy to penicillin, which is used to treat a wide range of infections, but data from a number of studies shows that the vast majority (90%) are not actually allergic.

Being incorrectly labelled as penicillin allergic can result in poorer patient outcomes, greater expenditure, more side effects, and it drives antibiotic resistance.

Joseph Brayson, a senior antimicrobial pharmacist at Northumbria Healthcare, said: “This overuse of penicillin allergy labels is a problem, because the alternative antibiotics aren’t always as effective for patients, so it’s better only to take them if it’s absolutely necessary.

“In addition, it’s a wider public health concern, because increased prescribing of the broader spectrum antibiotics is driving increased antibacterial resistance, where antibiotics lose their ability to treat infections properly.”

A pharmacist-led pilot took place involving more than 300 inpatients at the trust, with the initial screening process to assess suitability excluding 172 patients. This included those who were pregnant or breastfeeding or on regular immunosuppressant medication, for example.

However, the remaining 132 patients (43%) all had their penicillin allergy label successfully removed, following a process involving a ‘direct oral penicillin challenge’ where they were given a single dose of Amoxicillin under close observations from medical staff.

A paper on the Catalyst project was published in the Journal of Antimicrobial Chemotherapy earlier this year, while the team has also presented its findings at a number of international conferences.

However, Joseph explained that this was very much the starting point, with the aim of developing Catalyst to work at scale.

“We have been ahead of the curve on this, as we have been working on this for three or four years now, but there is now a much bigger drive nationally and regionally to look more closely at antibiotic allergies,” he said.

“I am helping to write some guidelines for both primary and secondary care, and we are working towards setting up a clinic so that patients can be referred by their GP to test their allergy status.

“We also need this process to become more embedded in healthcare practice as the pilot results showed that under two-thirds of patient medical records were updated appropriately to remove their penicillin allergy.”

Media contact

Ben O’Connell, external communications manager, Northumbria Healthcare

Benjamin.O'Connell@northumbria-healthcare.nhs.uk or 07833 046680.