The Benefits Of Penicillin De-Labelling

Dr Van Nieuwenhuysen
Dr Van Nieuwenhuysen

Dr Christian Van Nieuwenhuysen is an Anaesthetist with additional experience in the investigation of peri-operative drug allergies, including anaphylaxis in response to anaesthetic agents.

Table of Contents

Many people with the label of “penicillin allergy”  can be proven to be non-allergic and can then be “de-labelled”. The Benefits of Penicillin De-Labelling are potentially life-saving, as it allows access to penicillin and related antibiotics.

What is Penicillin De-Labelling?

Penicillin and other related antibiotics are among the most useful drugs ever discovered, but penicillins can cause unwanted reactions in some people. The most dangerous of these are allergic reactions, including life-threatening anaphylaxis. 

Up tp 15% of Australians have been told that they are allergic to penicillin, but studies have shown that less than 2% are truly allergic. Many patients labelled as penicillin allergic may never have been truly allergic to begin with, but may have experienced common non-allergic side-effects that are not dangerous. Others may have been allergic once, but their allergy is expected to have disappeared over time.

Penicillins are part of a large superfamily of antibiotics known as “beta-lactams”. This large family includes all antibiotics ending in “-cillin” and all antibiotics beginning with “ceph-” or “cef-”. A label of penicillin allergy often results in doctors avoiding prescribing all beta-lactams due to the risk of cross-allergy.

The Benefits of Penicillin De-Labelling are numerous. Use of non-beta-lactams (using suboptimal antibiotics instead) has been associated with 

  • Increased days in hospital when being treated for infection
  • Increased re-admissions to hospital when infection recurs
  • Increased chance of needing ICU for an infection
  • Increased antibiotic resistance developing in bacteria in society
  • Increased mortality from infections

On top of this, the overall risk of developing an infection after surgery goes up by around 50%. Post-surgical infection can affect the success of the surgery, and be life-threatening. Some particular surgeries carry even higher risks if beta-lactam antibiotics are avoided due to penicillin allergy.

Joint replacement surgery, cardiothoracic surgery, maxillofacial surgery and plastic surgery are particularly affected.

Penicillin allergy can also complicate pregnancy if you happen to need a Caesarean section or treatment for infection of any kind during pregnancy.

The Benefits of Penicillin De-Labelling should now be clear!

Queensland Anaesthetic Reaction Clinic offers Penicillin Allergy De-labelling in Brisbane through our clinic rooms based at Greenslopes Private Hospital. This can usually be done in a single appointment. Discuss the Benefits of Penicillin De-labelling with your GP or other specialist at the next opportunity!