Researchers at the Veterans Affairs (VA) Palo Alto Health Care System developed an informatics tool that can accurately detect antibiotic allergy adverse events. The tool was found to have an estimated probability of 30 percent or more, a positive predictive value of 61 percent, and a sensitivity of 87 percent.
A new study published in JAMA Network Open has found that an informatics tool can accurately detect antibiotic allergy adverse events. The technique, created by researchers at the Veterans Affairs (VA) Palo Alto Health Care Center, had an estimated chance of at least 30%, a positive predictive value of 61 percent, and a sensitivity of 87 percent for detecting antibiotic allergic-type reactions.
The tool was developed using data from 36,344 patients at VA hospitals who underwent cardiovascular implantable electronic device (CIED) procedures and received periprocedural antibiotic prophylaxis from October 1, 2015, to September 30, 2019. Patients were split into training and testing cohorts, and the researchers manually reviewed each case to determine the presence of allergic-type reactions and their severity.
The research team selected variables deemed potentially indicative of allergic-type reactions—including reported and observed allergies contained in the VA’s Allergy Reaction Tracking (ART) system, allergy diagnosis codes, medications given to treat an allergic reaction, and text searches of clinical notes for phrases that may indicate an antibiotic allergy reaction— to develop the tool.
The model was developed based on these data from the training cohort and then applied to the testing cohort.
The final algorithm included seven components to recognize antibiotic-allergic-type reactions. These components included PheCodes for “urticaria,” “symptoms affecting the skin,” and “allergy or adverse event to an antibiotic,” as well as reported and observed entries in the VA’s ART, the administration of antihistamines, and keyword detection in clinical notes.
The researchers believe that the tool could be used to improve the detection of antibiotic allergy adverse events, which could help clinicians avoid unnecessary antibiotic use. This is important because antibiotic resistance is a growing problem, and unnecessary antibiotic use can contribute to the development of resistance.
The findings from the study are a positive advancement in the fight against antibiotic resistance. Researchers are assisting in ensuring that antibiotics are only administered when they are required by creating methods that can accurately detect adverse antibiotic allergy occurrences. To safeguard the general public’s health and stop the spread of antibiotic resistance, this is crucial.
