Healthcare (Commonwealth Union) – Melbourne based scientists have led the largest international study to date showing that most people who are labelled as allergic to penicillin do not actually have the allergy.
The research, hailed as a “game changer” by lead author Professor Jason Trubiano, provides the first evidence that penicillin allergy testing can be carried out safely on a large scale as part of everyday hospital practice around the world.
Professor Trubiano, who heads Infectious Diseases at the University of Melbourne and is based at the Peter Doherty Institute for Infection and Immunity, led the international study published today in Clinical Infectious Diseases. The project included more than 5,000 patients from 40 hospitals across Australia, the United Kingdom, the United States, Canada, Malaysia, South Africa, Hong Kong and New Zealand.
The study was coordinated by Austin Health in partnership with the University of Melbourne, the Peter Doherty Institute and the National Allergy Centre of Excellence (NACE), which is based at the Murdoch Children’s Research Institute.
About one in ten hospital patients are listed as being allergic to penicillin, which restricts the range of antibiotics available for their treatment.
Among the 1,573 patients who were given a monitored test dose of penicillin during the study, 95% were safely shown not to be allergic. Their medical records were subsequently updated, allowing doctors to prescribe more appropriate first-line antibiotics and avoid unnecessary treatment delays.
Professor Trubiano, who also serves as Director of Infectious Diseases and Immunology at Austin Health, pointed out that inaccurate penicillin allergy labels represent a major global healthcare issue, and that these results signal an important transition from specialised research into widespread clinical practice.
He indicated that approximately 10% of hospital patients worldwide report a penicillin allergy, but most are not genuinely allergic and this is often due to misdiagnosis in childhood, the allergy fading over time, or a long gap since their last reaction.
Professor Trubiano indicated that misdiagnosis can result in inappropriate antibiotic prescribing, longer hospital stays, increased healthcare costs and more readmissions and their previous studies showed penicillin allergy testing could be done safely in smaller patient groups and specialist settings and the global study is a game-changer.
He also pointed out that for the first time, they have demonstrated this approach can be safely implemented at scale across entire hospital systems, utilizing technology to support clinicians and permitting hospitals globally to deliver this testing as part of routine care and for patients, that means faster access to the most effective antibiotics and improved treatment outcomes.
A major innovation tested in the study was a custom-designed smartphone tool that allowed doctors, pharmacists, and nurses to identify patients at low risk and safely give a monitored test dose of penicillin as part of standard hospital care—even in facilities without dedicated allergy specialists.
Elise Mitri, a PhD candidate at the University of Melbourne and a drug allergy pharmacist at Austin Health, said the results show the approach can now be rolled out safely on a large scale.
“This study shows penicillin allergy testing can be safely integrated into everyday hospital care, ensuring patients receive the most appropriate and effective treatment.
“The model is already being rolled out in hospitals across Australia and internationally.”
Building on the adult trial, the approach will now be extended to paediatric patients across six hospitals in Australia, in collaboration with the National Allergy Centre of Excellence (NACE), based at the Murdoch Children’s Research Institute (MCRI).
Professor Kirsten Perrett, Director of NACE and head of the MCRI Population Allergy Group, noted that around 5 per cent of children admitted to hospital report a penicillin allergy, with prevalence rising as they get older.
She added that the upcoming study will evaluate hundreds of children who have reported allergies to penicillin, cephalosporins, or sulfonamides.
