Healthcare professionalsʼ attitudes to penicillin allergy labels

Abstract
INTRODUCTION. About 10% of hospital inpatients are labelled with penicillin allergy in their electronic medical record (EMR).
However, allergy is confirmed in less than 10% of these records. Consequently, 90% of patients are treated with broadspectrum
antibiotics, contributing to antimicrobial resistance. We aimed to explore experiences and practices of healthcare
professionals that may explain incorrect labelling of penicillin allergy in Denmark and elucidate any consequences hereof.
METHODS. An electronic survey was distributed to physicians and nurses in six hospital units in Copenhagen and via social
media. The survey was active from 19 March to 1 May 2020. Data were assessed using descriptive statistics and by thematic
analysis.
RESULTS. The response rate was 44.6%. The survey had 369 participants; 152 physicians and 217 nurses. Half of the physicians
and one in every five nurses had experienced problems treating patients with a penicillin allergy label. Physicians reported
limited trust in allergy labels, and labelling practices varied. The risk that patients may be truly allergic was the main reason for
not removing labels (72%), and a precautionary principle was identified related to penicillin allergy labelling.
CONCLUSIONS. The penicillin allergy label is an independent factor of medication errors. Solutions to enhance patient safety
may include education of physicians in allergy labelling, decision support, standardisation of the allergy registration in the
various EMR systems used, and ideally also a national drug allergy register, which is accessible from all sectors.
FUNDING. None.
TRIAL REGISTRATION. Not relevant.
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