Antimicrobial Stewardship

World Antimicrobial Awareness Week 18 - 24 November 2021

Antimicrobial resistance (AMR) is a global crisis, slower burning than COVID-19 but potentially as catastrophic. It is a growing problem in Aotearoa New Zealand and may cost us dearly: longer hospital stays, poorer outcomes from interventions like surgery and cancer-related care, increased mortality, and elevated healthcare costs.

AMR will disproportionately impact the most socioeconomically disadvantaged amongst us, including Māori and Pacific Peoples, who are more susceptible to infections and have greater reliance on effective antimicrobial therapy.

World Antimicrobial Awareness Week (WAAW) is a chance to think about steps we can take to preserve antimicrobial effectiveness, and to act. 

Penicillin Allergy Initiative

For WAAW 2021, led by New Zealand's specialist Antimicrobial Stewardship and Infection pharmacists (NAMSIPEG), DHB public hospitals are raising awareness about the potential for incorrect penicillin allergy labelling and the harm it may cause.

Penicillin allergy is the most common adverse drug reaction reported.  However, while ~10% of adults believe they are penicillin allergic, most (~90%) do not have a true immune-mediated allergy. Incorrect penicillin allergy labels cause harm as they often lead to the use of second-line antibiotics that are less effective, broader spectrum and/or more toxic.

Read bulletin about penicillin allergy in adults and de-labelling

Implications for practice

There are various approaches to penicillin allergy 'de-labelling' across the country, between DHBs and between primary and secondary care. 

For clinicians in DHB hospitals, find out about your local policies and guidelines or have a chat with the local hospital pharmacy team about the approach. 

For clinicians in primary care, be aware this initiative may be happening in your local DHB hospital and patients may ask about their penicillin allergy. Formal referral pathways for oral challenges are not yet established for primary care.  Focusing on patients in the negligible risk category who may be de-labelled following interview and notes review alone (without the need for oral amoxicillin challenge or engagement with speciality services) might be the most straightforward way of incorporating this into practice currently. Check through your usual channels whether there are local policies or guidelines in your DHB or contact the DHB hospital pharmacy team.

If you’d like to know more or want to get involved, please contact one of the initiative leads:

Sharon Gardiner, Antimicrobial Stewardship Pharmacist at Canterbury DHB

Eamon Duffy, Antimicrobial Stewardship Pharmacist at Auckland DHB

Downloadable Resources 
Bulletin about Antimicrobial Resistance & World Antimicrobial Awareness Week
Penicillin Allergy Resources for Health Workers

* three different posters in file

Penicillin Allergy Resources for Consumers

* three different posters in file

WAAW Penicillin Allergy Screensaver & Email Signature

See previous initiatives: