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a petridish penicillin image July 3 2018

People who have a record of penicillin allergy are at an increased risk of developing meticillin resistant Staphylococcus aureus(MRSA) and Clostridium difficile.

The increased risk rises from using alternative broad spectrum β lactam antibiotics, researchers have found. “Systematically addressing penicillin allergies may be an important public health strategy to reduce the incidence of MRSA and C difficileamong patients with a penicillin allergy label,” they have concluded.

The study, published in the BMJ, involved patient records from over 300,000 patients in the UK, 64,000 of whose records recorded having a penicillin allergy. During a mean follow up period of 6.0 years, “1,365 developed MRSA (442 participants with penicillin allergy and 923 comparators) and 1,688 developed C difficile(442 participants with penicillin allergy and 1246 comparators).

“After adjusting for several known risk factors, the researchers found that a penicillin allergy label was associated with a 69% increased risk of MRSA and a 26% increased risk of C difficile,” said the BMJ. 

“Once documented, a penicillin allergy was associated with increased use of alternative ‘broad spectrum’ antibiotics.” Results indicate that broad spectrum antibiotics accounted for 55% of the increased MRSA risk and 25% of the increased C difficilerisk among patients with a known penicillin allergy.

Links:
BMJ announcement      
KG Blumenthal et al. ‘Risk of methicillin-resistant Staphylococcus aureus and Clostridium difficile in patients with a documented penicillin allergy: population-based matched cohort study’. BMJ 2018;361:k2400.     

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