Impact of Parent-Reported Antibiotic Allergies on Paediatric Antimicrobial Stewardship Programs
Date
Authors
Arnold, Annabelle
Coventry, Linda L
Foster, Mandie
Trevenen, Michelle
McKinnon, Elizabeth J
MacLindon, Sarah
Goff, Zoy H
Blyth, Christopher C
Lucas, Michaela
Supervisor
Item type
Journal Article
Degree name
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier BV
Abstract
Background Antimicrobial stewardship (AMS) is crucial for optimizing antimicrobial use and restraining emergence of antimicrobial resistance. The overall increase in reported antibiotic allergies in children can pose a significant barrier to AMS, but its impact on clinical AMS care in children has not been addressed. Objective To compare the clinical outcomes for children with a reported antibiotic allergy label (AAL) with those with no AAL reviewed by AMS. Methods A retrospective cohort study was conducted in a pediatric tertiary hospital, capturing 1590 inpatient admissions reviewed under the AMS between 2017 and 2019. Logistic, log-binomial, and Cox regression analyses were undertaken. Data collected included a documented AAL, antibiotic prescriptions, principal diagnosis, admitting specialty, hospital length of stay, intensive care admissions, and hospital readmissions. Results All 1590 pediatric patients were prescribed at least 1 antibiotic. AALs were recorded in 6.6% of patients; majority were β-lactam (82%), mostly penicillins (71%). AALs increased with age (P < .001); no gender effect was seen. Patients with AALs received more quinolones (P < .001), lincosamides (P = .001), aminoglycosides (P < .001), and metronidazole (P = .015) than patients with no AALs. In contrast, children with no AAL received more penicillin (P < .001). Children with any AAL had marginally longer hospital length of stay, median (interquartile range [IQR]) 7.0 (4.0, 15.0) days, than those without, median (IQR) 5.0 (3.75, 11.0) days, P = .027. Conclusion This study is the first to show how AALs impact clinical outcomes in children under an AMS program. With recent advances in delabeling, early intervention in cases of AAL should target children under AMS services who are in immediate need of optimal antibiotic management.Description
Keywords
3207 Medical Microbiology, 32 Biomedical and Clinical Sciences, Patient Safety, Emerging Infectious Diseases, Infectious Diseases, Infection, 3204 Immunology
Source
The Journal of Allergy and Clinical Immunology: In Practice, ISSN: 2213-2198 (Print), Elsevier BV. doi: 10.1016/j.jaip.2025.01.007