Saturday, August 18, 2018

Most who think they're allergic to penicillin aren't; that can lead to over-use of antibiotics and resistant infections, a big issue in Ky.

About 10 percent of Americans say or think they have a penicillin allergy, but 90 percent of those people are not truly allergic and could tolerate the drug, according to the U.S. Centers for Disease Control and Prevention.

CDC graphic
The CDC says this misconception results in millions of people taking "broad-spectrum antibiotics," which are more expensive and also increase the risk of antibiotic resistance. That's a big deal because it puts a person at risk of being infected by a life-threatening "superbug" that can't be treated.

Superbugs are strains of bacteria that have become resistant to antibiotics and include infections like methicillin-resistant Staphylococcus aureus, which is commonly called MRSA, and Clostridium difficile-related colitis, or C.diff. Both infections can be deadly.

The CDC says every year, at least 2 million people are infected with antibiotic-resistant bacteria and of those, 23,000 die as a direct result of these infections. Kentucky has one of the highest prescribing rates of antibiotics and has led the nation in infection rates for MRSA and CRE (carbapenem-resistant Enterobacteriaceae).

So, it's important to find out if you are truly allergic to penicillin. The CDC encourages everyone who thinks they have an allergy to penicillin to talk to their health care provider in detail about their allergy, and to discuss whether or not they need an allergy test to confirm it.

A new study, published in the British Medical Journal, found that people with a penicillin allergy are nearly 70 percent more likely to get a MRSA infection and 26 percent more likely to acquire C.diff. The study looked at six year's worth of medical records from patients in the United Kingdom who were enrolled in the Health Improvement Network database.

“All of us need to understand that antibiotic use is not a free ride; it carries a lot of risk,” Paul Sax, clinical director of infectious diseases at Brigham and Women’s Hospital in Boston, told Kate Furby of The Washington Post.

Sax, who was not involved in the study, told Furby that the new study adds to the “substantial body of evidence” showing that a penicillin allergy has been linked to longer hospital stays and an increased risk of acquiring resistant infections.

Diagnosing a penicillin allergy can be challenging. Experts told Furby that while symptoms like rash, nausea and diarrhea could be signs of it, these symptoms could also "coincidentally occur" when someone is taking the drug; that children often get rashes that are mistaken for a penicillin allergies; and that even if children are diagnosed correctly, they can grow out of the allergy.

Kim Blumenthal, lead author of the study and assistant professor of medicine at Harvard Medical School, told Furby that people should examine their own medical records, and if it's been more than 10 years since the diagnosis, they should talk to their doctor about getting retested.

Blumental said: “I would want patients to think, ‘Hmm, am I really allergic to penicillin, or did my mom just tell me and it’s not really true, and should I get that evaluated?’”

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