TOPLINE:

Children with a penicillin allergy label faced significantly higher risks for methicillin-resistant Staphylococcus aureus (MRSA) colonization, surgical site infections, and all-cause mortality than children without such labels.

METHODOLOGY:

• Researchers conducted a retrospective study using data from a large cohort of electronic health records across 68 healthcare organizations in the US to assess whether children with a penicillin allergy label had a higher risk for MRSA colonization, surgical site infection, and all-cause mortality.
• Eligible participants were younger than 18 years at their first encounter between 2007 and 2017 and had at least one visit during that period, as well as at least one subsequent visit between 2017 and 2024.
• After 1:1 propensity score matching, 125,792 children with a penicillin allergy label were paired with an equal number of children without the label.

TAKEAWAY:

• MRSA colonization occurred in 1.6% of children with a penicillin allergy label compared with 0.6% of those without, reflecting a more than twofold higher risk (relative risk [RR], 2.57; P < .001).
• Surgical site infection occurred in 0.7% of children with a penicillin allergy label compared with 0.2% of children without the label, corresponding to nearly a threefold higher risk (RR, 3.09; P < .001).
• The risk for all-cause mortality was also higher in children with a penicillin allergy label than in those without (RR, 1.78; P < .001).

IN PRACTICE:

“These findings highlight additional adverse outcomes associated with PAL [penicillin allergy label] in the pediatric population and draw attention to PAL as a potential modifiable risk factor that may be addressed to mitigate adverse health outcomes associated with unnecessary penicillin avoidance,” the authors of the study wrote.

SOURCE:

Heejo Keum, with the University of Texas Southwestern Medical Center, Dallas, was the corresponding author of the study, which was published online as a Letter to the Editor on June 8 in Pediatric Allergy and Immunology.

LIMITATIONS:

The study was limited by its retrospective design and reliance on diagnostic codes. Moreover, the platform used a limited number of variables that could be included in the propensity score matching.

DISCLOSURES:

The article does not list any specific funding source. One author disclosed receiving grant support from the National Institutes of Health, and another disclosed receiving support from the National Institutes of Health and the American Academy of Allergy, Asthma & Immunology Foundation Faculty Development Award.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.