198 patients with at least one infective episode were identified during the study period. Of these, 45 (23 %) had each antimicrobial allergy label (AA) and 153 (77 %) had no label (NAA). The groups were worthy of comparison with respect to age, sex, Charlson Comorbidity Index, mental health history, ICU-admission rate and actual death of numbers /30-day/60-day (Table 1).
Table 1. Characteristics of AA and NAA groups
Allergy labels & manifestations
In the AA patients, 62 allergy manifestations were recorded. Ten of the 62 allergy manifestations (16 %) were Type A unprosperous drug reactions (gastrointestinal 5; other 5). Of the Type B allergies (52/62; 84 %), IgE and T-enclosed space mediated manifestations were reported in 8/52 (15 %) and 44/52 (85 %) particularly. Antibiotic allergies were most commonly attributed to beta-lactams (65 %), followed through sulfonamides (11 %), glycopeptides (6 %), fluroquinolones (5 %), macrolides (5 %) and tetracyclines (2 %). More specifically, the causal antibiotic(s) included penicillin/aminopenicillins 23/62 (46 %), piperacillin-tazobactam 9/62 (14 %), trimethoprim/sulfamethoxazole 7/62 (11 %), vancomycin 4/62 (7 %), flucloxacillin 3/62 (5 %), ciprofloxacin 3/62 (5 %), cephalexin 2/62 (3 %), ceftazidimine 1/62 (2 %), cefepime 1/62 (2 %), cefuroxime 1/62 (2), dapsone 2/62 (3 %), metronidazole 2/62 (3 %), roxithromycin 2/62 (3 %), and doxycycline 1 (2 %).
Re-object to with the offending antimicrobial was besides likely if the allergy label was non-IgE mediated compared by IgE mediated (p = 0.024). Six of 44 patients with a rash (14 %) and 3/10 (30 %) by a Type A history were re-challenged. No formal SPT was recorded on this account that the AA group. The health professional reporting the antimicrobial allergy was undistinguished in 37/62 (60 %), physician in 19/62 (30 %), druggist 3/62 (5 %), surgeon 2/62 (3 %) and whole practitioner 1/62 (2 %).
Antimicrobial customary use & multivariate analysis
The median run over of antibiotics used per admission was significantly higher in the AA assign places to compared with the NAA group (3 vs. 2, p = 0.01), through a trend toward longer antibiotic continuation (15 days vs. 13 days, p =0.09). Concordance by 1st line therapy occurred less as a common thing in the AA group (21/45; 47 % vs. 139/153; 91 %, p < 0.001). There was ~t any difference in 30-day or 60-light of ~ mortality and LOS in the brace groups. The median number of readmissions and/or readmissions through an infectious disease diagnosis requiring antimicrobial therapy was higher during the AA group (Table 1). For one as well as the other first admission and re-admissions, ciprofloxacin (11.7 % vs. 4.7 %, p < 0.001), meropenem (12.1 % vs. 9.1 %, p = 0.21) and cefepime (9.3 % vs. 1.2 %, p < 0.001) appliance as percentage of total antibiotic menstrual flux was higher in AA group compared to NAA dispose. There was no difference in vancomycin appliance between the 2 groups (15 % vs. 15 %, p = 0.9). The percentage of whole antibiotic courses per antimicrobial class despite the AA and NAA groups is demonstrated in Fig. 1.
Fig. 1. The percentage of ~ity antibiotic courses (all admissions during study dot) per antimicrobial class for antimicrobial allergy (AA) and none antimicrobial allergy (NAA) groups. Abbreviations: AA, antimicrobial allergy clump; NAA, no antimicrobial allergy group. *P value < 0.05
On multivariate logistic return. adjusting for age group, inpatient surgery, sex, ICU initiation and LOS there was a higher readmission rate with an infective diagnosis (OR 3.27 95%CI 1.55-6.88, p = 0.002) and overall readmission rate (OR 1.99, 95%CI 0.95-4.15, p = 0.069) in the AA cluster compared with NAA group. The compute of antibiotics employed (regression coefficient 0.57, 95%CI 0.09-1.06, p = 0.021) and continuance of antibiotic therapy (regression coefficient 6.70, 95%CI 0.84-12.5, p = 0.03) was higher in the AA assemblage.
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