Guideline-based intervention improves the quality of antibiotic allergy registration in a hospital setting

Worldwide, up to a quarter of patients admitted to a hospital have an allergy registration for one or more antibiotics [ [1] Lee C.E. Zembower T.R. Fotis M.A. Postelnick M.J. Greenberger P.A. Peterson L.R. et al. The incidence of antimicrobial allergies in hospitalized patients: implications regarding prescribing patterns and emerging bacterial resistance. Arch Intern Med. 2000; 160: 2819-2822https://doi.org/10.1001/archinte.160.18.2819 Crossref PubMed Scopus (301) Google Scholar ]. Previous studies have shown that most of these labels are incorrect [ [2] Sacco K.A. Bates A. Brigham T.J. Imam J.S. Burton M.C. Clinical outcomes following inpatient penicillin allergy testing: a systematic review and meta-analysis. Allergy. 2017; 72: 1288-1296https://doi.org/10.1111/all.13168 Crossref PubMed Scopus (159) Google Scholar , [3] Salkind A.R. Cuddy P.G. Foxworth J.W. The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy. JAMA. 2001; 285: 2498-2505https://doi.org/10.1001/jama.285.19.2498 Crossref PubMed Scopus (243) Google Scholar ]. Incorrect allergy registrations and subsequent unnecessary use of second-line antibiotics have negative consequences for both the individual patients and society as a whole. In the Netherlands, a formal guideline was recently developed that provides recommendations for the approach towards suspected antibiotic allergy [ [4] The Dutch Working Party on Antibiotic Policy (SWAB) guideline for the approach to suspected antibiotic allergy. www.swab.nlDate accessed: December 2, 2022 Google Scholar ]. We assessed the outcome of a structured review of presumed-allergic reactions on antibiotic allergy registrations in patients admitted to the hospital.