Ten percent of people in BC believe they have a penicillin allergy. However, the vast majority of them are wrong: 90 percent of adults and 94 percent of children with a reported penicillin allergy can actually tolerate the antibiotic. This inaccuracy has serious implications, as these patients are likely to be given antibiotics which are less effective, have more side effects, are costly to the health care system and contribute to the growing threat of global antibiotic resistance.
Tiffany Wong, a pediatric allergist at BC Children’s Hospital, is tackling this widespread misdiagnosis through a multi-pronged approach that encompasses education, innovation, mentorship and research. Tiffany led a two-year study at the hospital’s allergy clinic, where she developed a drug allergy questionnaire and clinical algorithm for addressing the risk of a penicillin allergy. Over 90 percent of patients who participated in the study had their allergy status removed.
But she didn’t stop there. Since then, she has scaled up her efforts to support physicians in correctly assessing patient allergies. In addition to creating provincial and national guidelines on evaluating allergy status, Tiffany has created a mobile penicillin allergy de-labeling tool hosted by Firstline, which provides a real-time risk assessment of allergy and recommendations for care. The tool is designed to support physicians but is available to anyone who wants to access it, free of charge.
As well, Tiffany is leading a penicillin allergy de-labelling project within the hospital’s inpatient units which reviews the charts of patients with a reported allergy and updates them if the patient doesn’t have a true allergy. She is also providing leadership at other hospitals and community pediatric clinics across BC as they develop their own antibiotic allergy assessment programs.
And throughout this work Tiffany is translating knowledge for the general population. This past summer she was embedded within the Provincial Health Services Authority, through our Summer Student Internships in Quality & Safety Program, where she ran focus groups and individual interviews with patients and families labeled with penicillin allergy. New patient-facing infographics have been developed along with a satisfaction survey – the latest quality improvement project to in her quest to reduce erroneous labels of penicillin allergy.
Tiffany’s work has the potential to impact the way antibiotics are used worldwide, but it also has an impact on the individual patients who can access safe, appropriate antibiotics as a result of the tools and resources she has developed. And by decreasing the use of expensive non-penicillin antibiotics, Tiffany is making BC health care more sustainable and effective for all.