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Fight Antimicrobial Resistance - Check Again

Published 24/11/2022

November 18 – 24 is World Antimicrobial Awareness Week. Safer Care Victoria is joining with clinicians and patients to promote the safe and appropriate use of antibiotics.

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Antimicrobial resistance (AMR) occurs when the bacteria causing infections become increasingly resistant to treatment, meaning medicines such as antibiotics are no longer as effective.  

We spoke to A/Prof Jason Trubiano, Director of the Department of Infectious Diseases at Austin Health about antimicrobial resistance and what we’re doing to fight it.  

“Before COVID, antimicrobial resistance was the biggest infectious disease issue that we faced, with over 10 million people each year predicted to die from AMR by 2050”. 

People with a penicillin allergy are more vulnerable to this resistance, as they are unable to access the optimal antibiotics for their infection and may require multiple courses of alternative antibiotics to recover. 

However, most people who think they are allergic to penicillin aren’t. Only 1 in 10 hospitalised patients with a penicillin allergy have a true penicillin allergy. Sometimes they have outgrown it, yet the vast majority were never allergic in the first place. 

A/Prof Trubiano is the Clinical Lead for the 100,000 Lives initiative, Check Again, a statewide project introducing new approaches to assessment and testing to remove inaccurate penicillin allergies – one of the key weapons we have to fight AMR.  

“Having a penicillin allergy negatively impacts your care. And it’s come out in the last ten years that this is a public health emergency that really needs to be addressed”. 

Not assessing whether a patient is currently allergic to penicillin can lead to inappropriate or less effective antibiotic treatment options. This can lead to poor health outcomes, including extended hospital stays and complications, higher hospital readmission rates and increased antimicrobial resistance.  

In Dr Trubiano’s previous work in penicillin allergy assessment and testing at the Austin and Peter MacCallum hospital, patients with a penicillin allergy were first assessed to identify their level of allergy risk. Where this was low, the patient was offered a single test dose of penicillin under observation to safely remove their allergy.   

97% of people who received this test dose had a negative result, meaning they were actually not allergic. This opens up penicillin as a treatment option and ensures patients receive the right antibiotic at the right time for the right infection. 

Removing these allergies ultimately resulted in a 10-fold increase in the use of penicillins - decreasing the likelihood of antimicrobial resistance as well as reducing patients’ length of stay and readmissions to hospital.  

The initiative also has the tick of approval from patients – “Patients really love it - they were so excited to remove their red allergy armband. They received the antibiotic they needed, and their health improved faster.” 

In partnership with 13 health services across Victoria, Check Again is now working to increase inpatient access to penicillin allergy assessment and testing (for low-risk penicillin allergies).  So, whether you’re a clinician or a patient, when it comes to penicillin allergies it’s time to Check Again.   

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