Aim
This study aims to understand whether patients who have a recorded penicillin allergy experience different outcomes in intensive care and hospital settings compared with patients who do not have a recorded penicillin allergy.
The research will explore whether having a penicillin allergy recorded in a patient’s medical record affects the antibiotics they receive and whether this is associated with differences in recovery, length of stay in hospital, or survival.
Background
Penicillin is one of the most commonly used antibiotics and is used to treat a wide range of bacterial infections.
Around one in ten people report that they are allergic to penicillin. However, research has shown that many people who have a penicillin allergy recorded in their medical records may not have a true allergy. Some may have experienced side effects rather than an allergic reaction, while others may have had an allergy in the past that has since resolved.
A recorded penicillin allergy can influence treatment decisions. Healthcare professionals may choose alternative antibiotics instead of penicillin, even when penicillin would normally be recommended. In some cases, these alternative treatments may be less suitable, more costly, or increase the risk of complications.
Previous studies have suggested that patients with a recorded penicillin allergy may receive different patterns of antibiotic treatment and may experience different health outcomes. However, the reasons for these differences are not fully understood, particularly in patients who are critically ill.
Research
This study will use routinely collected healthcare data from patients admitted to intensive care units at Queen Elizabeth Hospital Birmingham between 2010 and 2019.
Researchers will compare patients who had a recorded penicillin allergy with those who did not. The study will investigate:
- Survival during and after a hospital admission.
- Length of stay in intensive care and hospital.
- Differences in the antibiotics prescribed.
- Use of different types of antibiotics.
- The relationship between antibiotic treatment and patient outcomes.
- Whether factors such as age, sex, severity of illness, and reason for admission influence the findings.
The study will include approximately 36,000 intensive care admissions, making it one of the largest UK studies to examine how a recorded penicillin allergy may affect care and outcomes in critically ill patients.
Patient and Public Involvement
Patients and members of the public have helped shape this research through discussions about antibiotic use and the impact of reported penicillin allergies on patient care.
Their views have helped inform the research questions and wider programme of work. Patients and public contributors will continue to work with the research team throughout the study, helping to guide the research and share the findings with patients, healthcare professionals and the wider public.
Approval
This project was unanimously supported by the PIONEER Data Trust Committee.
Project Lead
Dr Tony Whitehouse, Consultant in Critical Care and Anaesthesia, University Hospitals Birmingham NHS Foundation Trust
