Back in January 2019, 56-year-old Sharon Anne Robinson was admitted to Airedale General Hospital in Steeton, UK with a lower respiratory tract infection and was subsequently given amoxicillin, a type of penicillin antibiotic commonly used for such infections. She died 10 days later “as a result of administration of an antibiotic on January 27 which induced an anaphylactic reaction,” according to the coroner’s report.
An inquest into her death was held earlier this year and the testimony should be instructive for everyone that suffers from a drug allergy.
Robinson had a known allergy to amoxicillin which was documented in her medical records.
The coroner, Dr Anthony Howard, issued a Prevention of Future Deaths Report which is submitted if there is a risk of other deaths due to similar circumstances. In it, he raises the concern that a patient’s sensitivity to an antibiotic, despite the low risk, might be ignored leading to serious consequences.
You might think the story ends there, but there were complicating circumstances surrounding the administration of the drug.
The Airedale NHS Foundation Trust issued a response, which stated:
In the case of Mrs Robinson, the Trust’s evidence given at inquest was that Mrs Robinson’s recorded allergy to Penicillin was not ‘ignored’.
It was carefully considered when the treating clinician exercised their clinical decision making around whether or not it would be appropriate and safe to administer amoxicillin for a Lower Respiratory Tract Infection in January 2019.
The Trust’s evidence was that, before deciding to prescribe amoxicillin, the patient had reported to clinical staff that, notwithstanding the ‘allergy alert’ on her file, she had successfully been treated with amoxicillin on many previous occasions without any adverse reaction.
The Trust stated their assertion was backed up by Robinson’s medical records and that “it is right to explore the nature of an allergy” in line with guidance.
The response added:
This is even more so in circumstances where the condition in question is best treated by the antibiotic subject to the allergy alert, as was the situation in Mrs Robinson’s case.
They asserted the medication was not prescribed in ignorance of the allergy but the result of a “conscious decision” after the patient confirmed that she had not suffered adverse reactions from the drug over many years.
Our hearts go out to Mrs Robinson’s family for their terrible loss. We wish them solace, especially now after the inquest has no doubt surfaced painful memories.
We are not sure why the hospital did not test her for allergy to amoxicillin, which can be done by skin test or with a graded drug challenge where a small dose is first administered followed by increasing doses until the patient reaches the therapeutic dose.
If you were diagnosed with an allergy to a specific drug and believe you may no longer be allergic, we urge you to discuss this with your allergist to determine whether testing is warranted.
Please make sure when you are treated at a hospital to notify the staff of all foods and drugs to which you are allergic, even if you believe your medical records show such allergies.
Update to Safe Snack Guides and Allergence!