A groundbreaking initiative from Canberra's public hospitals has exposed a critical and widespread health issue: the vast majority of Australians who believe they are allergic to penicillin are not. This mislabelling is leading to the use of less effective antibiotics, longer hospital stays, and increased risks of serious infections.
Award-Winning Audit Uncovers Systemic Issue
The Canberra Hospital's antimicrobial stewardship team, led by senior clinical pharmacist Yolande Lindsay, launched a monthly audit in December 2022. Their work, which recently won a national award for clinical care excellence from the Australian Commission on Safety and Quality in Health Care, found that 12 per cent of 25,000 audited inpatients carried a penicillin allergy label.
However, the team's findings align with research from Sydney's St Vincent's Hospital, which indicates a staggering 90 per cent of these allergy labels are incorrect. Ms Lindsay explained that documentation of drug allergies is often poor, and many labels originate from childhood incidents.
"A lot of the time these allergies are put on from childhood," she said. "A doctor might have mistaken a rash caused by a virus for a reaction to the antibiotic, while many people grow out of allergies."
The Real-World Harm of an Incorrect Label
Carrying an incorrect penicillin allergy label is far from a benign administrative error. Infectious diseases specialist Dr Fabian Chong calls it a "huge problem" that actively causes harm.
When patients are labelled allergic, doctors are forced to prescribe second-line, broader-spectrum antibiotics. These alternatives are often less effective and come with a higher risk of side effects. Crucially, their use increases the likelihood of developing infections from multi-resistant bacteria, creating a dangerous cycle where future treatment options become severely limited.
Patients with a penicillin allergy label face significantly worse health outcomes. They are more likely to experience longer hospital admissions and have a higher risk of contracting urinary tract infections (UTIs) or painful bacterial skin infections like cellulitis.
Canberra's Solution: Testing and De-labelling
In response to their audit, the Canberra hospital team has taken proactive steps. Staff now directly approach inpatients with the allergy label to discuss their history and, if appropriate, conduct a supervised low-dose test.
"Most patients, if they're going to react, will react in the first 20 minutes, and it will only be a mild transient reaction," Ms Lindsay noted. By mid-September, almost none of the tested patients experienced adverse effects, allowing for the safe removal of the incorrect label.
The team's objective is clear: identify low-risk patients and safely remove inaccurate labels to restore access to first-line, most effective treatments.
What This Means for the Public
Ms Lindsay advises anyone who carries a penicillin allergy diagnosis, especially from childhood, to investigate its origins. "Find out what the reaction actually was when it occurred, how bad it was, what treatment you required," she recommends.
She encourages people to be open-minded, understanding that childhood reactions do not always equate to a lifelong allergy. "[Understand] that it wouldn't necessarily have a negative outcome, if anything, it might improve your healthcare," she said.
This initiative highlights a critical public health message: questioning and verifying long-held medical labels can lead to safer, more effective treatment and better overall health.
