Abstract
Older adults have an increased risk of adverse drug reactions and negative effects associated with alternative antibiotic use. Although number of antibiotic allergies reported increases with age, the characteristics and outcomes of older adults receiving drug allergy assessment are unknown.
To assess the characteristics and outcomes drug allergy evaluations in older adults.
We considered patients aged ≥65y enrolled in the United States Drug Allergy Registry (USDAR), a US multi-site prospective cohort (01/16/2019-02/28/2022). Data were summarized using descriptive statistics.
Of 1,678 USDAR participants from 5 sites, 406 older adults aged ≥65y (37% 65-69y, 37% 70-74y, 16% 75-79y, and 10% ≥80y) received 501 drug allergy assessments. USDAR older adults were primarily female (69%), White (94%), and non-Hispanic (98%). The majority of USDAR older adults reported ≤1 infections per year (64%) and rated their general health as good, very good, or excellent (80%). Of 296 (59%) penicillin allergy assessments in USDAR older adults, 286 (97%) were disproved. Other drug allergy assessments included sulfonamide (n=41, 88% disproved) and cephalosporin (n=20, 95% disproved) antibiotics. All 41 drug allergy labels in USDAR participants ≥80y and all 80 penicillin allergy labels in USDAR men ≥65y were disproved.
Older adults represented a quarter of USDAR participants but were neither racially nor ethnically diverse and were generally healthy without considerable antibiotic need. Most older adults presented for antibiotic allergy assessments, the vast majority of which were disproved. Drug allergy assessments may be underutilized in the older adults who are most vulnerable to the harms of unconfirmed antibiotic allergy labels.
