Prevalence of Antibiotic Allergy at a Spinal Cord Injury Center

Fed Pract, 2023 · DOI: 10.12788/fp.0378 · Published: May 19, 2023

Spinal Cord Injury Immunology Healthcare

Simple Explanation

This study investigates the prevalence of antibiotic allergies among patients with spinal cord injuries (SCI) at a single SCI center. Persons with SCI are at high risk for antibiotic overuse and hospital-acquired infection due to chronic bacteriuria, frequent health care exposure, implanted medical devices, and other factors. The study aims to determine the frequency of recorded antibiotic allergies in the electronic health records (EHR) of SCI patients. A study that reviews the exact frequency of antibiotic drug allergies listed on the EHR would be a key first step to identify the magnitude of this issue. By identifying the magnitude of antibiotic allergies, the study hopes to guide investigation into differentiating true allergies from adverse drug reactions (ADRs), which could widen options for antibiotic treatment. The results could guide investigation into differentiating true allergies from ADRs, thereby widening the options for potentially life-saving antibiotic treatment.

Study Duration

October 1, 2015, and September 30, 2017

Participants

1659 veterans with tetraplegia or paraplegia

Evidence Level

Level 3: Retrospective study

Key Findings

1
Almost 30% of patients with SCI had a recorded allergy to at least 1 antibiotic. Almost 30% of patients with SCI had a recorded allergy to at least 1 antibiotic.
2
The most common allergy was to penicillin (13.1%), followed by sulfa drugs (9.6%), and fluoroquinolones (4.5%). Penicillin (13.1%), sulfa drugs (9.6%), and fluoroquinolone (4.5%) were the most common allergens.
3
Only 11.9% of patients with a penicillin allergy had severe reactions. However, only 11.9% of patients with a penicillin allergy had severe reactions.

Research Summary

This retrospective study evaluated the frequency and characteristics of antibiotic allergies at a single SCI center. In this study, we evaluated the frequency and characteristics of antibiotic allergies at a single SCI center The study found a higher prevalence of antibiotic allergies in SCI patients compared to the general population, with penicillin being the most common allergen. A study in the general population used self-reported methods to collect such information found about a 15% prevalence of antibiotic allergy, which was lower than the 29.8% prevalence noted in our study. The authors suggest that differentiating true allergies from ADRs through methods like skin testing could help avoid unnecessary avoidance of certain antibiotics and combat antibiotic resistance. There are opportunities to examine whether approaches to confirm true reactions, such as skin testing, would help mitigate unnecessary avoidance of certain antibiotic classes

Practical Implications

Improve Allergy Recording

Improve the quality of antibiotic allergy recording in EHRs to differentiate between true allergies and adverse drug reactions.

Implement Allergy Testing

Consider implementing approaches to confirm true antibiotic allergies, such as skin testing, in SCI patients.

Promote Judicious Antibiotic Use

Encourage healthcare practitioners to discuss the risks and benefits of allergy testing with SCI patients to ensure judicious antibiotic use.

Study Limitations

1
Single-center retrospective study
2
Potential for underreporting of allergies occurring outside the VA system
3
Study reflects an overall prevalence of a single cohort without relationship to time

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