Related Experiment Video

Updated: Jul 17, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Prevalence of Trimethoprim-Sulfamethoxazole Adverse Reaction Mislabelling in Australia

Lydia Lam1,2, Melinda Jiang1,3, Stephen Bacchi1,2,4

  • 1Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.

International Archives of Allergy and Immunology
|September 6, 2023
PubMed
Abstract

Insights

Electronic medical records often mislabel adverse reactions to trimethoprim-sulfamethoxazole (TMP-SMX). This inaccurate allergy information may prevent patients from receiving this vital antibiotic.

Area of Science:

  • Pharmacovigilance
  • Clinical Informatics
  • Infectious Diseases

Background:

  • Trimethoprim-sulfamethoxazole (TMP-SMX) is crucial for treating Pneumocystis jirovecii pneumonia and MRSA.
  • Adverse reactions (AR) recorded in electronic medical records (EMR) may inaccurately restrict TMP-SMX use.
  • Previous studies show EMR AR data inaccuracies for other antibiotics.

Purpose of the Study:

  • To assess the accuracy of TMP-SMX adverse reaction (AR) labels in electronic medical records (EMR).
  • To determine the impact of misclassified AR on TMP-SMX usability in inpatient settings.

Main Methods:

  • Multi-center retrospective observational study over 2.5 years.
  • Collected and reviewed TMP-SMX ARs from EMRs by two independent medical officers.
  • Classified allergies and intolerances using pre-defined expert criteria.

Main Results:

  • TMP-SMX ARs were recorded in 0.6% of 759 inpatients.
  • Most ARs were misclassified: 17.5% of EMR labels were incorrect.
  • Rash, vomiting, and swelling were common ARs; 57.6% were allergies, 21.0% intolerances.

Conclusions:

  • Inaccurate TMP-SMX AR labels are common across various inpatient specialties.
  • User-entered allergy/intolerance classifications in EMRs are frequently incorrect.
  • Formal evaluation and relabeling of TMP-SMX ARs could improve antibiotic utilization.
Keywords:
AllergyAntibioticsAntimicrobial stewardshipDelabellingIntolerance

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