Transplant Patients with a Penicillin Allergy Label Experience a Higher Rate of Adverse Effects When Using Non-Penicillin Antibiotics


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“Test/provider availability and pre-test risk are probably two of the most important reasons not to evaluate reported penicillin allergies before surgeries.” – Ismael Carrillo-Martin, MD

Research slated for presentation at the 2021 American Academy of Allergy, Asthma & Immunology (AAAAI) Virtual Annual Meeting shows that organ transplant patients who have a penicillin allergy label are more likely to experience an adverse event when using non-penicillin antibiotics.

The abstract of this research was included in an online supplement to The Journal of Allergy and Clinical Immunology that was published February 1, with the full poster (#033) due to be presented at the 2021 AAAAI Virtual Annual Meeting.

Since individuals with a penicillin allergy label are given alternative antibiotic regimens, the researchers aimed to investigate if transplant patients with a penicillin allergy label would have worse outcomes from receiving alternative regimens.

Data from the National Inpatient Sample database between the years of 2005 and 2014 was reviewed for this study, and ICD-9 codes were used to identify organ transplant patients who also had a penicillin allergy label that were hospitalized with a primary infectious process. A retrospective analysis was done to compare outcomes between these patients to transplant patients treated for the same infections who did not have a penicillin allergy label.

A total of 1,170 transplant patients were identified who had a penicillin allergy label. Compared to the control group, transplant patients with the penicillin allergy label had a higher rate of adverse effects from non-penicillin antibiotics (8.9% compared to 6.3%).

The study compared the two populations according to additional criteria as well, and interestingly, transplant patients with a penicillin allergy label had a shorter hospital stay (4.9 days compared to 5.5 days) and a lower mortality rate while in the hospital (1.6% compared to 2.7%). The transplant patients with a penicillin allergy label also had a lower rate of infection with multi-drug resistant organisms (0.3% compared to 1%). Both groups had similar results when it came to MRSA and surgical wound infections, as well as the average cost of hospitalization.

“Some of the alternative antibiotics used as prophylaxis in patients with reported penicillin allergies have more frequent and at times more serious non-allergic adverse effects (explaining the almost 2% difference in rate of adverse events), which makes it important to evaluate these reported allergies in the pre-surgical setting when possible,” said Ismael Carrillo-Martin, MD, one of the study authors. “Test/provider availability and pre-test risk are probably two of the most important reasons not to evaluate reported penicillin allergies before surgeries. Studying systematic pre-surgical approaches or protocols to evaluate these allergies pre-operatively could provide valuable information regarding the benefits and utility of promoting the use of these protocols in a more standardized manner.”

Visit aaaai.org to learn more about drug allergies and visit annualmeeting.aaaai.org to learn more about the 2021 AAAAI Virtual Annual Meeting.

The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has over 7,000 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

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