Challenging penicillin allergy

Dr Richard Sullivan is an Infectious Diseases Staff Specialist at St George Hospital and one of three recipients of the 2022 Early Career Medical Research Grants awarded by SSMRF. Dr Sullivan is passionate about his work in infectious diseases, saying, “It is extremely varied, and you get to work with a number of different people and teams, which I really enjoy”.

Dr Sullivan and his team’s new project, Point of care antibiotic allergy assessment and intervention, aims to “significantly enhance and improve antimicrobial prescribing in people who report a penicillin allergy. Around 90 per cent of people who report a penicillin allergy are actually not allergic on further testing and can safely receive antibiotics in the penicillin class. Inaccurate penicillin allergy labelling is associated with inappropriate antimicrobial prescribing, antimicrobial resistance, higher costs, readmission rates and increased length of stay. If we can correct people’s antibiotic allergies at the time of admission when they receive antibiotics, we can ensure we are giving optimal antibiotic therapy and improve their outcomes”.

The funding will allow Dr Sullivan and his team to employ a registered nurse (RN) for a day a week. The RN will “actively identify inpatients who have been prescribed a restricted antibiotic due to a penicillin allergy”. The RN will use existing electronic tools at the hospital, such as the electronic health record and antimicrobial stewardship decision support system, to identify such inpatients. Dr Sullivan and his team “will actively review these patients and, if appropriate and with informed consent, challenge them to the implicated antibiotic.”

“We will measure outcomes such as the number of patients who have their antibiotic allergy removed, restricted antibiotic use, penicillin antibiotic use and length of stay.”

Through the work, Dr Sullivan and his team “hope to show that active surveillance of antibiotic allergy leads to improved antibiotic prescribing and outcomes for our patients.”

“This will add to the evidence that most penicillin allergies are not true allergies. This will improve antibiotic prescribing in this group by actively identifying and reviewing them using existing hospital systems.”

As an outcome of the challenges, Dr Sullivan and his team will “correct patients’ penicillin allergy labels so that they can receive antibiotics in the penicillin class, so they can receive optimal therapy for their current infection. This will also provide many more antibiotic options for them to treat infections in the future.”

Dr Sullivan studied medicine at UNSW and completed his physician training in Infectious Diseases in 2019. He has recently completed a graduate certificate in Allergic Diseases from Western Sydney University. In addition to working full time in his role as Infectious Diseases Staff Specialist at St George Hospital and completing his research project research, Dr Sullivan is also working on a PhD on hepatitis B in the Northern Territory through the Menzies School of Health Research, Charles Darwin University. Dr Sullivan has published journal articles on the treatment of melioidosis, hepatitis b epidemiology and diagnosis, and Covid-19.

Outside work, Dr Sullivan enjoys walking his dog and cooking for fun and relaxation.

Join SSMRF in supporting medical research and significantly impacting our community’s health and wellbeing. SSMRF CEO Pam Brown said, “As a community, we have the power to transform the landscape of medical research and positively impact the health and wellbeing of people locally and around the world. By donating to the SSMRF grants program, you can play a vital role in supporting medical research initiatives at St George and Sutherland Hospitals, enabling SSMRF to sponsor more research projects annually. Let’s support transformative medical research through our collective efforts.”

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