The Burden of Self-Reported Antibiotic Allergies in Healthcare and How to Address It: A Systematic Review of the Evidence Hand in Hand: A Systematic Review of the Evidence

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aut.relation.endpageS2198
aut.relation.journalJournal of Allergy and Clinical Immunology: In Practice
aut.relation.pages5
aut.relation.startpageS2213
dc.contributor.authorArnold, Annabelle
dc.contributor.authorCoventry, Linda
dc.contributor.authorFoster, Mandie
dc.contributor.authorKoplin, Jennifer
dc.contributor.authorLucas, Michaela
dc.date.accessioned2023-07-19T03:55:01Z
dc.date.available2023-07-19T03:55:01Z
dc.date.issued2023-07-21
dc.description.abstractBackground: Antibiotics are the first line treatment for bacterial infections; however, overuse and inappropriate prescribing has made antibiotics less effective with increased antimicrobial resistance. Unconfirmed reported antibiotic allergy labels create a significant barrier to optimal antimicrobial stewardship in healthcare, with clinical and economic implications. Objective: A systematic review was conducted to summarise the impact of patient-reported antibiotic allergy on clinical outcomes and various strategies that have been employed to effectively assess and remove these allergy labels, improving patient care. Methods: The review was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A critical appraisal was conducted on all studies and a narrative synthesis was performed to identify themes. Results: Four themes emerged, the prevalence of antibiotic allergy, impact of antibiotic allergy on antimicrobial prescribing, impact of antibiotic allergy on clinical outcomes and delabeling strategies to improve clinical outcomes. Of the 32 studies, including 1,089,675 participants, the prevalence of reported antibiotic allergy was between 5-35%. Patients with a reported antibiotic allergy, had poorer concordance with prescribing guidelines in 30-60% of cases, with a higher use of alternatives such as quinolone, tetracycline, macrolide, lincosamide and carbapenem and lower use of beta-lactam antibiotics. Antibiotic allergy delabeling was identified as an intervention and recommendation to advance the state of the science. Conclusion: There is substantial evidence within the literature that antibiotic allergy labels significantly impact on patient clinical outcomes and a consensus that systematic assessment of reported antibiotic allergies, commonly referred to as "delabeling", improves the clinical management of patients.
dc.identifier.citationJournal of Allergy and Clinical Immunology: In Practice, ISSN: 2213-2198 (Print), Elsevier, S2213-S2198. doi: 10.1016/j.jaip.2023.06.025
dc.identifier.doi10.1016/j.jaip.2023.06.025
dc.identifier.issn2213-2198
dc.identifier.urihttp://hdl.handle.net/10292/16433
dc.publisherElsevier
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S2213219823006682
dc.rightsCopyright © 2023 Elsevier Ltd. All rights reserved. This is the author’s version of a work that was accepted for publication in (see Citation). Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. The definitive version was published in (see Citation). The original publication is available at (see Publisher's Version)
dc.rights.accessrightsOpenAccess
dc.subject3204 Immunology
dc.subjectantibiotic allergy; antimicrobial stewardship; delabeling; drug allergy
dc.titleThe Burden of Self-Reported Antibiotic Allergies in Healthcare and How to Address It: A Systematic Review of the Evidence Hand in Hand: A Systematic Review of the Evidence
dc.typeJournal Article
pubs.elements-id513669
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