Fighting antibiotic allergy

Hospital pharmacists need to be included into collaborative programs to tackle antibiotic allergies, say Australian researchers.

Academics from a range of institutions questioned 277 allergists, clinical immunologists and hospital pharmacists to ascertain their knowledge and service delivery regarding antibiotic allergies.

They found that there were widespread knowledge gaps around the prevalence of penicillin allergy sand mechanisms of cross-reactivity, despite almost half of the respondents (43%) having over ten years clinical experience.

“Compounding whether a true or perceived absence antibiotic allergy testing, is a potential misunderstanding of antibiotic allergy, previously noted in the US,” the authors said.

As well as boosting this level of knowledge, multidisciplinary service models were needed, with pharmacists playing a greater role in these teams       

The majority of respondents said there were currently barriers to testing for antibiotic allergy. A referral process involving a combined immunology/infectious disease stream was the preferred model to improve testing, being backed by 47% of respondents.

Referral by a pharmacist was backed by 38% of respondents, while 45% backed referral by an AMS physician or an allergist.

Pharmacists were the biggest supporters of a partnership model between “infectious diseases, pharmacy and immunology”, with 62% of pharmacists surveyed endorsing this concept.

Just under half of the infectious diseases physicians supported this model, and only 17% of allergists and immunologists.

“Despite a high antibiotic allergy label prevalence and demand for AAT services, current implementation barriers include lack of access to appropriate specialist healthcare providers to carry out AAT as well as cost of delivery,” the authors concluded.

“A collaborative model of infectious diseases physicians, pharmacists and allergists/clinical immunologists would enable targeted AAT delivery to those that require it, improving antibiotic utilisation, choice and drug safety.

Current knowledge gaps suggest that education of clinicians and pharmacists and engagement of allergy and infectious diseases networks will be needed to provide the change necessary to fuel such multidisciplinary service models”.  

The study was published in Internal Medicine Journal

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