Cohort studycited by the Tayebat archiveabstract only checked A-ABX-21 standard review
Penicillin allergy label and resistant infections
Risk of meticillin resistant Staphylococcus aureus and Clostridium difficile in patients with a documented penicillin allergy: population based matched cohort study.
Overview
Blumenthal KG et al.. BMJ 2018 · PMID 29950489 · DOI 10.1136/bmj.k2400
People labelled penicillin-allergic had more MRSA and C. difficile, partly due to alternative antibiotics.
Does the study support the specific claim? Yes · Methodological quality: high
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Link.
- How was the study done?
Cohort.
- How many people, animals or samples were studied?
301,399.
- What was actually found?
Higher risk.
- How large was the observed effect?
aHR 1.69.
- What do the results mean in everyday life?
Allergy labels should be checked.
- What are the study's limitations?
Observational.
- What does it say about Elawady's specific claim?
Supports.
- Do the results apply to Germany and Europe?
High.
Scientific in-depth review
1. Full reference
- Authors
- Blumenthal KG, Lu N, Zhang Y, Li Y, Walensky RP, Choi HK
- Journal
- BMJ
- Year
- 2018
- Identifier
- PMID 29950489 DOI 10.1136/bmj.k2400 · PMC6019853
- Verification
- verified – PubMed E-utilities efetch, 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
2. Research question
Penicillin allergy label and MRSA/C. difficile
3. Study design and population
- Study design
- Cohort study – Population-based matched cohort (THIN)
- Population
UK adults
- Country
UK
- Period
1995-2015
- Sample size
64,141 allergy; 237,258 comparators
4. Methods and endpoints
- Exposure / intervention
Penicillin allergy label
- Comparator
Matched
- Endpoints
MRSA, CDI
- Statistical methods
Adjusted HR
5. Actual results
- Results
MRSA aHR 1.69 (1.51-1.90); CDI aHR 1.26 (1.12-1.40); alternative antibiotics explained 55% (MRSA) and 35% (CDI).
- Absolute risks
not reported
- Authors' conclusion
Addressing penicillin allergy labels may reduce MRSA and CDI.
6. Strengths
- Mediation analysis
7. Weaknesses
- Observational
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
11. Independent contrary findings
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Supports careful drug choice.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | high |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | unknown |
| Consistency with the overall evidence | unknown |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
Use by the Tayebat archive
Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.
- What the archive says about the study
Bibliography only.
- A. What was actually studied?
Allergy label.
- B. What did the authors find?
Higher MRSA/CDI.
- C. What conclusions do the authors themselves draw?
De-label.
- D. What does the archive derive from it?
Harm of alternatives.
- E. Is this derivation scientifically justified?
Justified.
- Adequacy of the interpretation (by the archive)
- not applicable