- Title
- Antimicrobial anaphylaxis: the changing face of severe antimicrobial allergy
- Creator
- Hall, Victoria; Wong, Micah; Cheng, Allen C.; Stewardson, Andrews J.; Aung, Ar K.; Trubiano, Jason A.; Munsif, Maitri; Stevenson, Brittany R.; Elliott, Katie; Lucas, Michaela; Baird, Ashleigh J.; Athan, Eugene; Young, Melissa; Pickles, Robert
- Relation
- NHMRC.GNT1139902 http://purl.org/au-research/grants/nhmrc/GNT1139902
- Relation
- Journal of Antimicrobial Chemotherapy Vol. 75, Issue 1, p. 229-235
- Publisher Link
- http://dx.doi.org/10.1093/jac/dkz422
- Publisher
- Oxford University Press
- Resource Type
- journal article
- Date
- 2020
- Description
- Objectives: The epidemiology, clinical characteristics and outcomes of antimicrobial-associated anaphylaxis remain ill-defined. We sought to examine antimicrobial anaphylaxis with regard to: (i) the frequency of implicated antimicrobials; (ii) attributable mortality; and (iii) referral for definitive allergy assessment. Methods: This was conducted through a national retrospective multicentre cohort study at five Australian tertiary hospitals (January 2010 to December 2015). Cases of antimicrobial anaphylaxis were identified from ICD-10 coding and adverse drug reaction committee databases. Results: There were 293 participants meeting the case definition of antimicrobial anaphylaxis and 310 antimicrobial anaphylaxis episodes. Of 336 implicated antimicrobials, aminopenicillins (62/336, 18.5%) and aminocephalosporins (57/336, 17%) were implicated most frequently. ICU admission occurred in 43/310 (13.9%) episodes; however, attributable mortality was low (3/310, 1%). The rate of anaphylaxis to IV antibiotics was 3.5 (95% CI=2.9–4.3) per 100 000 DDDs and the rate of hospital-acquired anaphylaxis was 1.9 (95% CI=2.1–3.3) per 100 000 occupied bed-days. We observed overall low rates of hospital discharge documentation (222/310, 71.6%) and follow-up by specialist allergy services (73/310, 23.5%), which may compromise medication safety and antimicrobial prescribing in future. Conclusions: This study demonstrated that a high proportion of severe immediate hypersensitivity reactions presenting or acquired in Australian hospitals are secondary to aminopenicillins and aminocephalosporins. Overall rates of hospital-acquired anaphylaxis, predominantly secondary to cephalosporins, are low, and also associated with low inpatient mortality.
- Subject
- hypersensitivity; anaphylaxis; follow-up; intensive care unit; mortality; antimicrobials; Sustainable Development Goals; SDG 3; SDG 7
- Identifier
- http://hdl.handle.net/1959.13/1426640
- Identifier
- uon:38446
- Identifier
- ISSN:0305-7453
- Language
- eng
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