Infections and Immunology Health Network
Dr James Flexman, Lead
- Drug allergy – the case of penicillin
- Updated ‘Management of Staphylococcus Aureus Bacteraemia’ guidelines (2014)
- Needle and Syringe programs update
The Infections and Immunology Health Network has identified drug allergy as a priority area given the importance of this issue across WA Health.
Although penicillin was the first antibiotic to be identified and introduced into clinical practice in the 1940s it, and closely related beta-lactam antibiotics, remains one of the most effective antibiotics for the treatment of Gram positive bacterial infections.
Possibly due to its common and widespread use a significant number of people experience adverse reactions during their treatment with penicillin ranging from mild skin rashes to life threatening anaphylactic reactions. Given that adverse drug reactions can be more severe on subsequent exposure it is not surprising that clinicians have tended to label all patients who have experienced even a mild adverse reaction as penicillin allergic. This has meant that a significant number of people, estimated as up to 20% of the general population, are now denied access to penicillin.
This has ramifications for the effective antimicrobial treatment of the population as a large number of sizeable studies have shown that on average people labelled as penicillin allergic have worse outcomes than non-allergic people. Most people are labelled as antibiotic-allergic as children; however, no reliable data assessing Australian children with antibiotic allergy are available.
The Australian Society of Clinical Immunology and Allergy (external site) has recently established a working party to provide guidance to clinicians on how to best manage drug allergy in their patients and to develop sustainable pathways to assess patients with the label of drug allergy.
Furthermore, a study in WA children has been funded by the PMH Foundation to allow for improved diagnostics and care for children with the label of drug allergy.
The Western Australian Committee for Antimicrobials has released the updated ‘Management of Staphylococcus Aureus Bacteraemia’ guidelines (PDF 90KB) (SAB). Developed by the Western Australian Infectious Diseases Physician Group, a key change is the distinction between complicated and uncomplicated cases of SAB.
Needle and syringe programs (NSP) are a key intervention in preventing the transmission of hepatitis B, C and HIV from and amongst people who inject drugs and the wider community.
NSPs are an important aspect of sharps safety. Following the successful Sharps Safety Forum held in October 2014, the Infections and Immunology Health Network plans to establish a sharps safety community of practice. This will bring together people involved in infection control and sharps safety both in hospital and the community. The 2014 sharps safety forum report (PDF 187KB) is now available on the Infections and Immunology Health Network website. Please contact firstname.lastname@example.org to register your interest in becoming a member of the community of practice.
The Communicable Disease Control Directorate, WA Department of Health reports on NSP activity across WA. Recent highlights include:
This report provides a summary of responses to an annual survey received from NSP Coordinators across Western Australia.
This report describes the number of needles and syringes distributed in Western Australia from 2004 to 2013, including regional data.
The Sexual Health and Blood-borne Virus Program, in partnership with HepatitisWA, have recently completed a trial of a needle and syringe vending machine at Armadale Health Service, the first machine to be trialled at a metropolitan hospital. Currently the machines are operated successfully at a number of rural hospitals. This report documents the review and evaluation of the trial. The evaluation concluded that the model of machine and ongoing incidents of vandalism made it difficult to maintain the needle and syringe vending service. The report makes several recommendations regarding identifying potential issues to overcome in providing similar services at other sites in the future.