Prevalence of antibiotic allergy labels and their consequences in people presenting to a teaching hospital Emergency Department; a retrospective chart review

Background: Antibiotic allergy labels have a direct impact on individual patient care and on the consumption of broad-spectrum antibiotics. Objective: Our aim was to establish the prevalence of antibiotic allergies and to determine whether patients with doc-umented antibiotic allergy labels received guideline concordant antimicrobial therapy. Additionally we wanted to evalu-ate the quality of allergy documentation in the medical record. Method: Prospective audit of all patients presenting to the Emergency Department of an adult teaching hospital in Sydney over a 4 month period. Documented allergy labels, diagnoses, antibiotic administration and outcomes were recorded. Appropriateness of antibiotic choice was based on the Australian National Antimicrobial Prescribing Survey. Results: 9.9% of presentations had at least one antibiotic allergy recorded. Significantly more women than men had an-tibiotic allergies documented. One third of patients with documented antibiotic allergies were prescibed inappropriate antibiotic therapy and some had significant adverse events. Conclusion: The documentation of antibiotic allergy labels and choice of antibiotic treatment can be significantly im-proved. Strategies to safely de-label people with documented allergies who are not truly allergic need to be implement-ed.