ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2026
Sex-based differences in penicillin allergy labeling among adults in a Canadian ambulatory urgent medicine clinic: a cross-sectional study.
Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Penicillin allergy labels (PALs) affect about 10% of people, are mostly low risk, and more common in females. Sex-based differences in prevalence and characteristics remain unclear. This study examined associations between sex, PAL, and relevant covariates, in an Ontario ambulatory hospital population. Methods: A cross-sectional study of adults ( ≥18 years) seen at the hospital's Urgent Medicine Clinic from 2015-2024 was conducted. Descriptive statistics compared patients by PAL status. Unadjusted and multivariable logistic regression models evaluated associations between sex and PAL, adjusting for covariates. Results: Among 29,645 patients (59.7% female), 3,026 (10.2%) had a documented beta-lactam allergy, of which 2,777 (9.4%) were PALs, and most (91.7%) were low risk. Females were twice as likely to have a PAL (11.6% vs 6.0%; unadjusted OR 2.17, 95% CI 2.14-2.19) and more often reported multiple medication allergies (30% vs 16%; OR 2.25, Conclusion: Approximately 10% of patients had a PAL, mostly low risk and female predominant. Multivariable analysis identified female sex, atopy, older age, and multiple medication allergies as independent predictors; autoimmune and metabolic conditions were not. Longitudinal studies using validated allergy data and intersectionality can guide equitable evaluation.
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