Antibiotic allergy labelling: addressing an important public health issue

As we hear about rises in iGAS, the issue of antibiotic allergy – and specifically penicillin allergy – labelling comes to the fore. A good review here outlines some of the issues in this complex space, and makes some helpful suggestions about how this could be improved.

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Antibiotics and the Netherlands

Schermafbeelding 2015-09-13 om 21.03.43

Antimicrobial resistance, control of antibiotic use and infection control are some of the things the Dutch presumably do well. Some of the Dutch infection control policies, such as “Search & Destroy” helped to stop the introduction of MRSA for a long time. I addition, the prevalence of other MDRO is low in comparison to many other countries. Still, more needed to be done, and consequently, the Dutch were (one of) the first that made antimicrobial stewardship teams (A-teams) compulsory for every hospital and presently plan introduction in other healthcare settings. Last but not least, the fight against antimicrobial resistance will be an important topic, while the Dutch hold the Presidency of the European Union in the first half of 2016.

Thus, what else could we ask for? A few weeks ago, I had at least one request: basic antibiotics.

Due to fading reimbursement policies and the constant pressure to sale drugs for decreasingly lower prices, the production for and/or distribution of several drugs within the Netherlands is no longer possible. Latest victim: i.v. penicillin, which is no longer available in my country (high-resource setting). While it seems difficult to argue for small spectrum antibiotics in the absence of one of the important ones, there is some good news: I no longer have to argue whether to use penicillin or a 3rd generation cephalosporin for certain indications. Ceph it is!