{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T19:38:44Z","timestamp":1761507524762,"version":"build-2065373602"},"reference-count":13,"publisher":"CSIRO Publishing","issue":"4","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":388,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Australian Capital Territory Health Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gonorrhoea notifications have increased substantially in Australia over the past decade. Neisseria gonorrhoeae is already highly resistant to several antibiotics and so, alternatives to first-line treatment are generally strongly discouraged. The penicillin allergy label (AL) on patient medical records has previously been shown to influence prescribing practices, to the detriment of best-practice management and antimicrobial stewardship. This study aimed to understand how the penicillin AL influences antibiotic selection for gonorrhoea treatment at Canberra Sexual Health Centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart audit of gonorrhoea cases treated at Canberra Sexual Health Centre between January 2020 and October 2023 (n\u00a0=\u00a0619 patients, n\u00a0=\u00a0728 cases). Antibiotic selection was assessed according to penicillin AL status. Ceftriaxone selection was assessed according to penicillin allergy severity reported in the medical records and as determined using a validated antibiotic allergy assessment tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cases with a penicillin AL were more likely to receive antibiotics other than ceftriaxone (n\u00a0=\u00a07\/41, 17.1%) than cases without the label (n\u00a0=\u00a08\/687, 1.2%, P\u00a0&amp;lt;\u00a00.000). Most penicillin ALs had non-specific severity ratings in the medical records, but had insufficient information (n\u00a0=\u00a028\/41, 68.3%) to apply the assessment tool. Those reported as low-severity in the records were more likely to receive ceftriaxone (n\u00a0=\u00a021\/22, 95.5%) than those reported as moderate\u2013high (n\u00a0=\u00a07\/11, 63.6%) or unreported (n\u00a0=\u00a06\/8, 0.75%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Treatment of gonorrhoea in outpatient settings requires an understanding of penicillin allergy, and the ability to quickly and accurately identify penicillin-AL patients who can safely tolerate ceftriaxone. Institutionally endorsed penicillin allergy de-labelling protocols and access to easy-to-navigate prescribing advice within national sexually transmitted infection management guidelines would support this.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh24066","type":"journal-article","created":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T20:56:30Z","timestamp":1720990590000},"source":"Crossref","is-referenced-by-count":0,"title":["First-line treatment with ceftriaxone for Neisseria gonorrhoeae infection less likely to be prescribed to patients with a penicillin allergy label: a retrospective audit of medical records"],"prefix":"10.1071","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8726-8111","authenticated-orcid":true,"given":"E.","family":"Durban","sequence":"first","affiliation":[{"name":"AResearch School of Biology, Australian National University, Canberra, ACT, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-0465","authenticated-orcid":true,"given":"K.","family":"English","sequence":"additional","affiliation":[{"name":"BCanberra Sexual Health Centre, Canberra Health Services, Garran, ACT, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Evans","sequence":"additional","affiliation":[{"name":"BCanberra Sexual Health Centre, Canberra Health Services, Garran, ACT, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9325-1647","authenticated-orcid":true,"given":"S.","family":"Martin","sequence":"additional","affiliation":[{"name":"BCanberra Sexual Health Centre, Canberra Health Services, Garran, ACT, Australia."},{"name":"CSchool of Medicine and Psychology, Australian National University, Canberra, ACT, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"issue":"4","key":"2025102615352552900_R1","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.idc.2023.06.005","article-title":"Penicillin allergy impact and management.","volume":"37","author":"Wrenn","year":"2023","journal-title":"Infect Dis Clin North Am"},{"issue":"1","key":"2025102615352552900_R2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.6510","article-title":"Penicillin allergy is not necessarily forever.","volume":"318","author":"Trubiano","year":"2017","journal-title":"JAMA"},{"issue":"10167","key":"2025102615352552900_R3","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/S0140-6736(18)32218-9","article-title":"Antibiotic allergy.","volume":"393","author":"Blumenthal","year":"2019","journal-title":"Lancet"},{"issue":"2","key":"2025102615352552900_R4","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1111\/j.1398-9995.2008.01924.x","article-title":"Update on the evaluation of hypersensitivity reactions to betalactams.","volume":"64","author":"Blanca","year":"2009","journal-title":"Allergy"},{"issue":"6","key":"2025102615352552900_R5","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1111\/all.12390","article-title":"Natural evolution of skin-test sensitivity in patients with IgE-mediated hypersensitivity to cephalosporins.","volume":"69","author":"Romano","year":"2014","journal-title":"Allergy"},{"issue":"5","key":"2025102615352552900_R6","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.15323","article-title":"Antibiotic selection for suspected Neisseria gonorrhoeae infection among penicillin-allergic patients in the emergency department.","volume":"13","author":"McGuinness","year":"2021","journal-title":"Cureus"},{"key":"2025102615352552900_R7","unstructured":"STI Guidelines Australia. Gonorrhoea. 2021. Available at https:\/\/sti.guidelines.org.au\/sexually-transmissible-infections\/gonorrhoea\/"},{"key":"2025102615352552900_R8","unstructured":"Therapeutic Guidelines. Approach to Neisseria gonorrhoeae infection. 2019. Available at https:\/\/tgldcdp.tg.org.au\/viewTopic?etgAccess=true&guidelinePage=Antibiotic&topicfile=neisseria-gonorrhoeae&guidelinename=Antibiotic&sectionId=toc_d1e128#toc_d1e128"},{"issue":"6","key":"2025102615352552900_R9","doi-asserted-by":"publisher","first-page":"192","DOI":"10.18773\/austprescr.2019.065","article-title":"Penicillin allergy: a practical approach to assessment and prescribing.","volume":"42","author":"Devchand","year":"2019","journal-title":"Aust Prescr"},{"issue":"1","key":"2025102615352552900_R10","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.mayocp.2017.09.020","article-title":"Evaluation and management of penicillin allergy.","volume":"93","author":"Pongdee","year":"2018","journal-title":"Mayo Clin Proc"},{"issue":"1","key":"2025102615352552900_R11","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1111\/j.1749-6632.2011.06215.x","article-title":"Antibiotic resistance in Neisseria gonorrhoeae: origin, evolution, and lessons learned for the future.","volume":"1230","author":"Unemo","year":"2011","journal-title":"Ann N Y Acad Sci"},{"key":"2025102615352552900_R12","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1016\/j.jaip.2018.07.048","article-title":"Pathways to improved antibiotic allergy and antimicrobial stewardship practice: the validation of a beta-lactam antibiotic allergy assessment tool.","volume":"7","author":"Devchand","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2025102615352552900_R13","unstructured":"Australian Government Department of Health and Aged Care. National communicable disease surveillance dashboard. Australian Government Department of Health and Aged Care; 2024. Available at https:\/\/nindss.health.gov.au\/pbi-dashboard\/"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/doi\/10.1071\/SH24066\/588065\/sh24066.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/doi\/10.1071\/SH24066\/588065\/sh24066.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T19:35:34Z","timestamp":1761507334000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/21\/4\/SH24066\/82263\/First-line-treatment-with-ceftriaxone-for"}},"subtitle":[],"editor":[{"given":"Michael","family":"Marks","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,8,8]]}},"URL":"https:\/\/doi.org\/10.1071\/sh24066","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"type":"print","value":"1448-5028"},{"type":"electronic","value":"1449-8987"}],"subject":[],"published":{"date-parts":[[2024,7,15]]},"article-number":"SH24066"}}