Assessing the impact of penicillin allergy on surgical-site infections
Research type
Research Study
Full title
Investigating the impact of penicillin allergy labels on rates of surgical site infection and selection of antimicrobial resistance in elective surgical patients at Cambridge University Hospitals NHS Foundation Trust
IRAS ID
301935
Contact name
Stephen Baker
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Approximately one in every eight inpatients (12.8%) at Addenbrooke’s hospital has a ‘penicillin allergy’ alert in their medical records. Such labels significantly influence the choice of antibiotics given to patients during surgery to prevent infection, although evidence suggests that up to 90% of 'penicillin allergy' labels can be safely removed through formal allergy testing. Recent studies in USA and Canada found that people with ‘penicillin allergy’ labels are more likely to suffer infection after surgery. However, we do not know whether this is true in the UK, where the antibiotics used and background rates of antibiotic resistance among bacteria are markedly different. The impact of penicillin and non-penicillin antibiotic use in UK surgery on the selection of antibiotic resistance also remains unknown. The large intestine houses a large pool of bacteria that gives rise to the majority of surgical infections, and it is well known that exposure of these bacteria to antibiotics can drive the development of antibiotic resistance. Our project will use a large database of surgical procedures undertaken at Addenbrooke’s hospital since January 2015 to examine the relationship between penicillin allergy labels and surgical-site infections, and will also invite a small number of patients to submit stool samples before and after surgery to enable close observation of the effects of antibiotic use during surgery on key markers of antibiotic resistance in the large intestine, using targeted bacterial DNA tests. Patients submitting stool samples will be enrolled from surgical pre-assessment clinic at Addenbrooke's hospital and will submit 3 stool samples in total (pre-surgery, and at 1 and 7 days post-surgery). They will have a final telephone follow-up call at 30 days post-surgery.
REC name
East of England - Cambridge East Research Ethics Committee
REC reference
21/EE/0292
Date of REC Opinion
27 Jan 2022
REC opinion
Further Information Favourable Opinion