Penicillin allergy and surgical prophylaxis: Cephalosporin cross-reactivity risk in a pediatric tertiary care center

Journal of Pediatric Surgery
Ralph J BeltranJoseph D Tobias

Abstract

First generation cephalosporins are commonly used as antibiotic prophylaxis prior to surgery. Patients labeled as penicillin-allergic are often precluded from receiving cephalosporins because of an allergic cross-reactivity. The aims of this study were to evaluate the clinical practice for surgical prophylaxis at Nationwide Children's Hospital and to determine the incidence of adverse effects and allergic reactions when using cephalosporins in patients labeled as penicillin-allergic. A retrospective chart review was performed to identify patients who were allergic to penicillin, penicillin antibiotic family, who required surgical treatment for an existing medical condition, and received an antibiotic to prevent surgical site infection. Five hundred thirteen penicillin-allergic patients were identified, encompassing 624 surgical cases. Cephalosporins were administered in 153 cases (24.5%) with cefazolin used 83% of the time. Only one documented case of nonanaphylactic reaction was reported. Clindamycin was the most common cephalosporin substitute (n=387), and the reported adverse reaction rate was 1.5%. No cases of anaphylaxis were documented. Our data suggest that the administration of cephalosporins for surgical prophylaxis fo...Continue Reading

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Citations

Nov 12, 2016·The Journal of Allergy and Clinical Immunology. in Practice·Werner Aberer
Apr 4, 2017·Current Opinion in Otolaryngology & Head and Neck Surgery·Andrew O'Keefe, Moshe Ben-Shoshan
Jan 24, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kimberly G BlumenthalErica S Shenoy
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Nov 11, 2018·Paediatric Anaesthesia·David L SommerfieldBritta S von Ungern-Sternberg
Aug 1, 2019·Pharmacy : Journal of Pharmacy, Education and Practice·Saira B ChaudhryJamie L Wagner
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Jun 3, 2021·Current Opinion in Allergy and Clinical Immunology·Javier FernandezNatalia Blanca-Lopez
Aug 26, 2021·JAMA Surgery·Meghan N JeffresKimberly G Blumenthal

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