- Title
- Antibiotic allergy de-labelling in the perioperative setting
- Creator
- Pons, Benjamin
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2023
- Description
- Masters Research - Master of Philosophy (MPhil)
- Description
- Background: Patients labelled as “allergic” to penicillin and cephalosporin antibiotics often receive alternative therapies for surgical antimicrobial prophylaxis. These treatments are less effective and associated with poor outcomes. Aims: The major aims of this thesis are to: 1. Assess the degree to which antibiotic allergy labels to penicillin and cephalosporin antibiotics influence rates of administering first-line antibiotics according to national guidelines 2. Implement a sustainable allergy assessment and de-labelling process within the perioperative clinic 3. Measure the impact de-labelling participants has on the adherence to recommended first-line antimicrobial prophylaxis for surgery. Secondary aims were to: 1. Determine the safety of allergy testing by non-allergy specialists 2. Determine the feasibility and efficiency of this approach; in respect to time spent in the perioperative clinic. Methods: The first study (PAPER 1) primarily focussed on measuring the degree by which antibiotic allergy labels lead to sub-optimal antibiotic prescribing. The second study (PAPER 2) was a before and after quasi-experimental study. The primary objective was to compare rates of optimal antibiotic prescribing before and after the introduction of a perioperative antibiotic allergy de-labelling program. Results: To summarise the main findings of the two papers: 1. This research elucidated that approximately 20-25% of patients with antibiotic allergy labels to penicillin and cephalosporin antibiotics are receiving sub-optimal antibiotics for surgery. 2. The introduction of a perioperative penicillin and cephalosporin allergy de-labelling program was associated with an improvement in antibiotic prescribing for surgery by 8%. To summarise the secondary findings: 1. Allergy risk-stratification, testing and de-labelling can be performed safely by non-allergy specialists prior to surgery. 2. This practice appears feasible and does not adversely increase appointment duration for elective surgical patients. Conclusion: Allergy de-labelling in the perioperative setting provides a unique opportunity to improve antibiotic prescribing for surgery. Such an intervention corresponds with key recommendations from healthcare governing bodies to prescribe targeted therapy wherever possible.
- Subject
- antibiotic prophylaxis; antimicrobial stewardship; cefazolin; cephalosporin; cross reactions; drug hypersensitivity; de-labelling; penicillin
- Identifier
- http://hdl.handle.net/1959.13/1477146
- Identifier
- uon:49921
- Rights
- Copyright 2023 Benjamin Pons
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 16 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 522 KB | Adobe Acrobat PDF | View Details Download |