The global prevalence of reported penicillin allergy: A systematic review and meta-analysis
Bibliographic record
Abstract
OBJECTIVES: Patients labelled with penicillin allergy (PenA) often receive broader spectrum antibiotics, associated with antimicrobial resistance and poorer outcomes. However, ∼95% of patients are likely mis-labelled. Whilst de-labelling programmes are gaining momentum, they have been restricted to a few countries. Here, we address the global prevalence of PenA, to inform the wider potential impact for de-labelling programmes. METHODS: We conducted a systematic review and meta-analysis including all studies on adult PenA prevalence between January 2003 and June 2023. Data on PenA prevalence, allergy recording methods, healthcare setting, and country income were extracted. This study is registered on PROSPERO (CRD42023437718). RESULTS: 174 studies from 28 countries were included (18,352 screened). Global PenA prevalence was 9·4% (95% CI 8·4-10·4%). 92% of peer-reviewed publications were from high-income countries(HICs), with 72% from the UK, USA or Australia. HICs had higher PenA prevalence 9·9% (95% CI 8·8-11·0%), compared to middle-income countries (MICs), 4·4% (95% CI 2·8-6·2%), p<0.0001. Primary care data was seldom reported (16% of studies), and the method of allergy recording significantly influenced reported prevalence. CONCLUSIONS: Studies reporting PenA prevalence are skewed towards HICs and secondary care, with little data from Africa, most of Asia and South America. This highlights an unmet need to broaden epidemiological analysis in under-represented regions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".