Drug allergy

iNAAN-Kids

Improving paediatric antibiotic allergy identification and testing

Patient-reported antibiotic allergies, most commonly to penicillin, are a major public health concern.

An estimated 18 per cent of all hospitalised Australians report an antibiotic allergy, and around five per cent of children are impacted – a rate that increases with age.

When children with an antibiotic allergy go to hospital, they often receive less effective antibiotics to treat infection and some experience longer hospital stays.

Yet, only one in 10 Australians who report having a penicillin allergy are truly allergic. In children, genuine beta-lactam (penicillin and cephalosporin) allergies are rare, with over 90% of children able to have their allergy removed following testing. This may be because they have outgrown the condition or were misdiagnosed.

Study overview

The NACE has partnered with the International Network of Antibiotic Allergy Nations (iNAAN) to introduce iNAAN-Kids.

iNAAN-Kids will audit existing clinical programs at participating hospitals to measure the safety and antimicrobial prescribing outcomes of inpatient paediatric antibiotic allergy assessment and delabelling via direct challenge. To do this, the national study will:

• Roll out a purpose-built paediatric digital antibiotic allergy toolkit in hospitals to help identify and assess children with a reported penicillin, cephalosporin or sulfonamide allergy label
• Offer a direct challenge to children with a low-risk antibiotic allergy during their hospital admission to confirm their true allergy status
• If the result is negative, they will have their antibiotic allergy label removed from their medical record.

At least 400 antibiotic allergy assessments of patients under the age of 18 will be analysed as part of the study. Most participants found to have ‘low-risk’ antibiotic allergy labels are expected to be safely delabelled, leading to better antibiotic use, improved health outcomes, and lower hospital costs.

In adults, a similar study showed 97 per cent of inpatients with a low-risk penicillin allergy were safely delabelled, improving their subsequent antibiotic prescribing and saving money.

The results of this study could help improve how paediatric antibiotic allergy is identified, assessed and tested in Australia – and help inform clinical guidelines, public health programs and policy to address one of the country’s greatest paediatric health challenges.