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Barwon Health / Research

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Research in Focus: The changing face of severe antimicrobial allergy

Monday, 03 August 2020

Anaphylaxis is a severe, sudden allergic reaction that can be fatal. Recent studies show that deaths and hospital admissions due to anaphylaxis are on the rise, especially those suspected to be caused by a patient’s reaction to antimicrobial medicines they may be taking, such as antibiotics (used to treat bacterial infections) and antifungals (used to treat fungal infections).

However, little is known about which antimicrobial medications are implicated in anaphylaxis, and what are the effects and consequences.

To find out, Barwon Health was one of five hospitals across Australia that studied patients who experienced an anaphylactic reaction while taking antimicrobial medication. Key findings included:

  • Almost 2/3 of cases occurred in the community, with the patient then being transported to hospital, while the remaining cases occurred while the patient was in hospital.
  • The most common antimicrobials being taken by these patients were amoxicillin or ampicillin (both antibiotics), followed by cephalexin (an antifungal), which aligns with their current positions as the most commonly prescribed antimicrobials in Australia.
  • Just over 1 in 10 of patients required admission into ICU. There was a low mortality rate of 1% that could be attributed to the anaphylaxis.
  • A third of patients reported that they had experienced antimicrobial allergic reactions or adverse effects before this event.
  • Follow-up by specialist allergy services observed in only ¼ of patients.

The findings from this study should act as a call for an increase in resources to support a standardised reporting system for antimicrobial anaphylaxis as well as compulsory follow ups by specialist allergy services. These steps would be a step forward in preventing patients from being re-exposed to medications that may bring about anaphylaxis.


Antimicrobial anaphylaxis: the changing face of severe antimicrobial allergy


Victoria Hall, Micah Wong, Maitri Munsif, Brittany R. Stevenson, Katie Elliott, Michaela Lucas, Ashleigh J. Baird, Eugene Athan, Melissa Young, Robert Pickles, Allen C. Cheng, Andrew J. Stewardson, Ar K. Aung and Jason A. Trubiano


Journal of Antimicrobial Chemotherapy, Volume 75, Issue 1, January 2020, Pages 229–235


Infectious Diseases