The impact of antimicrobial allergy labels on antimicrobial usage in cancer patients

Antimicrobial Resistance and Infection Control

Karin A. Thursky¹  Monica A. Slavin¹  Leon J. Worth²  Man Y. Chu²  Vivian K. Leung²  Jason A. Trubiano³ 

[1]Victorian Infectious Diseases Service, Peter Doherty Institute, Melbourne, Australia

[2]Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia

[3]Department of Infectious Diseases, Austin Health, East Melbourne, VIC, Australia

关键词: Antimicrobial resistance;    Cancer;    Stewardship;    Antibiotic allergy;   

Others  :  1210228
DOI  :  10.1186/s13756-015-0063-6

 received in 2015-01-28, accepted in 2015-05-19,  发布年份 2015

【 摘 要 】

Background

Antibiotic allergy labels are associated with sub-optimal prescribing patterns and poorer clinical outcomes in non-cancer populations, but the effect of labelling on antimicrobial usage in patients with cancer is unknown.

Findings

A retrospective review of hospitalized patients admitted to the Peter MacCallum Cancer Centre (2010-2012) identified 23 % of cancer patients (n = 198) with an antimicrobial allergy label (AA). Comparison of those with an antimicrobial allergy label to those without demonstrated increased antibiotic use per admission (3 vs. 2, p = 0.01), increased fluoroquinolone use (11 % vs. 6 %, p < 0.05), increased antibiotic course duration (15 vs. 13 days, p = 0.09), higher readmission rates (53 % vs. 28 %, p < 0.001) and poorer concordance with prescribing guidelines (47 % vs. 91 %, p < 0.001). Patients in the AA group on multivariate analysis had a higher number of antibiotics employed, longer duration of antibiotic therapy and higher rate of readmission.

Conclusions

Antimicrobial usage, including the use of restricted antibiotics, is higher in patients with cancer. Antibiotic de-labelling strategies in cancer patients must be evaluated to aid antimicrobial stewardship initiatives.

【 授权许可】

   
2015 Trubiano et al.; licensee BioMed Central.

【 图 表 】

Fig. 1.

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