Interview highlights
The discussion aimed to persuade pediatricians to identify patients with false penicillin allergy labels, allowing for their removal and enabling the future use of penicillin, promoting responsible antibiotic use.
- Around 20% of patients have penicillin allergy labels, but only 5% are genuinely allergic. Misunderstood symptoms and family history often lead to these false labels, which persist from childhood into adulthood.
- Pediatricians can educate parents about the rarity of true penicillin allergies and the safety of in-office challenges, confirming that 95% of labeled patients aren't allergic. However, studies show limited proactive action, with few patients referred for allergy testing.
- Delabeling false penicillin allergies is vital to reduce unnecessary antibiotic use, adverse effects, hospital stays, and healthcare costs. Education of both healthcare providers and patients is essential to address this issue effectively.
Interview transcript (edited for clarity):
Contemporary Pediatrics®:
Why did you want to discuss penicillin allergy labels at the 2023 American Academy of Pediatrics National Conference & Exhibition?
Paul V. Williams, MD, FAAP:
The whole purpose was to try and convince primary care pediatricians that they can help us in finding all these patients who have false labels for penicillin allergy and remove that label from their medical records so that they can use that drug in the future.
Contemporary Pediatrics:
How does a false penicillin label happen?
Williams:
The interesting thing is the label is usually applied in childhood, and then nobody does anything about it, it remains with that patient until they're an adult, to the point that up to 20% of patients seeking medical care will have a penicillin allergy label, but only 5% of those will be truly penicillin allergic. The problem with that is that they start using, because they have that penicillin allergy label, more expensive broad spectrum antibiotics, which leads to more adverse effects, longer hospital stays, cost more money, more resistant organisms, all of those things happen. For antibiotic stewardship purpose, we want to find out who's truly allergic and avoid it in that group, but let's delabel as we call it, that 95% of those patients who aren't truly allergic. But you ask why does that happen,and there are a lot of reasons why. Some people will think "there's a family history of penicillin allergy, so I don't want my child to have penicillin," So they say they're allergic to penicillin, or they had symptoms that weren't probably due to an allergy, so they're more intolerant to the drug than allergic to the drug, but just for convenience sake, so people don't use it again, they'll put down allergic to penicillin. Sometimes the reaction isn't known. So since you don't have a history, you want to play it safe. So you put down an allergy label, or they get some sort of rash when they've got this viral infection and they're being treated with antibiotics for convenience or safety will put that label on them, but never do anything about it. So that label sticks.
