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In Progress

This is an innovation project supported by the Better Care Victoria Innovation Fund.

Lead organisation

Austin Health

Partner

Peter MacCallum Cancer Centre

Summary

More than two million Australians report an antibiotic allergy, but studies have shown that 85 per cent of these allergy ‘labels’ are false and can be disproven by allergy testing. 

False antibiotic allergy labels can result in patients receiving inappropriate or less effective antibiotic therapies, potentially leading to poor health outcomes, extended hospital stays and complications, increased antimicrobial resistance, higher hospital readmission rates, and sometimes even death.

Austin Health and partner organisation Peter MacCallum Cancer Centre are trialling a program that identifies and assesses patients reporting an antibiotic allergy. 

Patients with a low-risk penicillin allergy assessment are offered a single test dose of penicillin during their hospital stay to disprove and safely de-label their penicillin allergy. Direct de-labelling (removal) of the antibiotic allergy is recommended for patients with a no-risk antibiotic allergy assessment. 

De-labelling false antibiotic allergies ensures patients can be treated with the most effective and appropriate antibiotic therapies.  

Aims

  • Identify all patients admitted to Austin Health and Peter MacCallum Cancer Centre with a documented antibiotic allergy
  • Introduce a hospital-wide validated antibiotic allergy assessment tool to standardise antibiotic allergy assessment amongst healthcare workers
  • Improve patient safety by improving the accuracy and completeness of antibiotic allergy documentation in the electronic medical record 
  • Implement a cost-effective point-of-care oral penicillin challenge program that improves access to vital antibiotic allergy testing services and safely de-labels 85 per cent of penicillin allergies amongst patients who undergo testing
  • Increase the use of preferred and appropriate antibiotics by 30 per cent to reduce hospital admission costs and hospital length of stay amongst de-labelled patients

Update

October 2020 – While this innovation project is still in the process of being finalised, early results have been positive. 

Of the patients who received an oral penicillin challenge test, 97 per cent were found to have a false allergy label. The subsequent de-labelling of these patients led to a 10-fold increase in penicillin antibiotic use. 

Certain aspects of the project were published in Clinical Infectious Diseases in August 2020.

Page last updated: 17 Dec 2020

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