Safely Preventing Errors and Complications due to Inappropriate Allergy Labelling Study (SPECIAL Kids)

Clarifying the true antibiotic allergy status of children and developing adequate testing strategies for antibiotic allergy

If an unexpected reaction occurs during antibiotic treatment, the patient or the prescribing doctor often suspect an antibiotic allergy. This assumption can lead to a patient reporting they have an allergy on subsequent presentation to another provider or to hospital staff. At this point the patient is said to be antibiotic-allergy ‘labelled’ because alerts are attached to ensuing clinical documentation, and patients are assigned allergy-identifying wristbands. This procedure is designed to protect the patient from harm by alerting providers to avoid prescribing a drug that will result in anaphylaxis.

Six percent of Western Australian children report an allergy label as do up to 25 per cent of general medical patients, but up to 90 per cent of adults who report a penicillin allergy can tolerate the drug and are not truly allergic. The consequences associated with restricted options are far-reaching and include suboptimal antibiotic treatment, readmissions with infections and increased lengths of stay. The SPECIAL studies (SPECIAL Kids and SPECIAL Adults) are randomised controlled trials to examine the safety and clinical outcomes of challenging unverified antibiotic allergy labels in the outpatient and inpatient hospital settings, respectively.


Fewer patients in the health system reporting incorrect allergy labels

Safer antibiotic prescribing

Decreased morbidity

Collaboration and funding

We were funded in 2019 via a UWA Research Impact Grant (a collaborative effort with the National Allergy Strategy and Allergy & Anaphylaxis Australia) to inform and engage the community with the topic of antibiotic allergy in children and adults. To do this, we are establishing an online profile within WA Health, UWA and via the professional and consumer organisations mentioned.

We have arranged a local consumer forum (via the WA Health Translation Network) and a consumer engagement forum to be convened by Dr Norman Swan (Radio National’s ‘Health Report’) at the Australian Society for Immunology and Allergy Conference to be held in Perth in September 2019, which is likely to reach a national audience.

Logo of Allergy and Anaphylaxis Australia        Logo of National Allergy Strategy

We have received significant funding from Perth Children’s Hospital Foundation and WA Health Department Health Translation Project.

Logo of Perth Children’s Hospital Foundation




Contact Clinical Professor Michaela Lucas