Is it a true penicillin allergy? How penicillin allergy de-labelling is making care safer and more effective – featuring Dr. Tiffany Wong

Approximately 10% of the population (which translates to around 500,000 people in BC) believes they have a penicillin allergy and are labelled as such in their patient records, but in reality, more that 90% of these patients do not have a true penicillin allergy.  These false penicillin allergy labels can have serious consequences to both individual patients and the system; a false allergy label can lead to the use of an alternative antibiotic, which may have increased side effects, increased costs, and can lead to antibiotic resistance. Proactively ‘de-labelling’ patients that have an inaccurate penicillin allergy label can help avoid these risks. Dr. Tiffany Wong is a pediatric allergist based at BC Women’s and Children’s Hospital and is an advocate for choosing the best medications for patients, which involves proving or refuting true drug allergies. Dr. Wong and her team have developed a mobile de-labelling tool to support healthcare providers to do this work in their own settings with their patients. This involves a risk assessment and follow-up processes to accurately diagnose patients deemed as high-risk in a way that is safe, standardized, and evidence based. She has also been working with patient partners to co-design patient resources, so patients and caregivers can be empowered to understand penicillin allergies. These resources are available at https://www.dropthelabel.ca/. This work is also currently being adopted at the University Hospital of Northern BC, with support from the Spreading Quality Improvement Initiative, so the benefits of penicillin allergy de-labelling, and associated improvements to patient care, will be realized in the North. Dr. Wong also shares how having a pet and participating in family based activities with her children and husband out in nature helps her to avoid burnout.

Links:

Drop the Label resources for providers, patients, and caregivers: https://www.dropthelabel.ca/

Assessment of multiple-opinion referrals and consults at the BC Children’s Hospital Allergy Clinic
Allergy, Asthma & Clinical Immunology Adam P. Sage and Elliot James and Megan Burke and Edmond S. Chan and Tiffany Wong DOI: 10.1186/s13223-023-00806-2
06/2023