Antibiotic Allergies are Not Well-Documented

Few documented antibiotic allergies are correct, according to a new study from the Netherlands published in the Annals of Family Medicine.

Antibiotics are among the most commonly prescribed medications. However, most physicians and pharmacists rely on inaccurate records of the patient’s antibiotic allergies while determining the most appropriate prescription. These records may be incomplete, unclear, or incorrect, which can lead to antibiotic resistance, higher health care costs, and decreased patient safety, according to the press release.¹

The qualitative study was conducted among 34 family physicians and 10 pharmacists and employed 4 focus group discussions based on purposeful sampling and a naturalistic approach. The discussions were audio-recorded and transcribed verbatim and were then analyzed by means of constant comparative technique, according to the study.²

Study authors found 3 main themes. The first was the magnitude and awareness of the problem of inappropriate antibiotic allergy documentation. The second was the origin of the problem, and the third was approaches for addressing the problem.

The magnitude of contamination of medical files with inappropriate documentation leads to skepticism around current documentation, according to the study. Family physicians and pharmacists also indicated that they do not believe they have sufficient knowledge about antibiotic allergies.

“Other knowledge gaps that emerged in our study have been discussed in literature; for example, family physicians and pharmacists were seldom aware that the time between intake of an antibiotic and a reaction is rarely noted in medical records, and that an antibiotic allergy is not a permanent condition,” the study authors wrote in the discussion.²

The study authors identified electronic communication and electronic health record systems as major hindering factors. Physicians and pharmacists believe more tools are needed to rectify inappropriate allergy documentation.²

Reference:

• Antibiotic allergy reporting may lead to resistance, higher costs, decreased safety (News Release), July 14, 2020, EurekAlert!, Accessed July 15, 2020
• De Clercq, Kitty et al. Inappropriate Antibiotic Allergy Documentation in Health Records: A Qualitative Study on Family Physicians’ and Pharmacists’ Experiences (study) Netherlands, July/August 2020, Annals of Family Medicine, accessed July 15, 2020