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    DOACs associated with reduced risk of major bleeding compared to warfarin

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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
More inWhite Papers  

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 an 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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