- This cross-sectional study examined surgical encounters of patients who received cefazolin in the perioperative setting (four hours before surgery to four hours postoperatively) to evaluate the incidence rate of anaphylaxis in patients with and without a penicillin allergy label (PAL). The authors reviewed medical records of all patients who received cefazolin for surgical prophylaxis at Johns Hopkins Healthcare System facilities from July 1, 2017, to July 1, 2020. Cefazolin was administered in 112,817 total surgical encounters; 4876 involved patients with a PAL.
- In conducting the study, the authors first set aside all records containing tryptase orders or diphenhydramine administrations to identify encounters that potentially involved perioperative anaphylaxis. 1421 surgical encounters met inclusion criteria for manual review, and the authors identified 284 cases in which the patient experienced an immediate hypersensitivity reaction. Those 284 records were reviewed by allergy specialists, who determined perioperative anaphylaxis occurred in 22 instances, and 13 were plausibly related to cefazolin. Of those 13 encounters, only 1 patient had a PAL.
- The authors’ research affirms perioperative anaphylaxis following administration of cefazolin is a rare occurrence (0.02%), and they found there is no statistically significant difference in the rate of cefazolin-induced reactions experienced by PAL patients versus non-PAL patients.
- The study’s results demonstrate cefazolin can be safely administered to PAL patients in the perioperative setting. Since research suggests PAL patients are at a higher risk of surgical-site infections, facilities and clinicians should reevaluate their guidelines to help mitigate microbial transmission and advance patient safety.
Summary of "Examining cefazolin utilization and perioperative anaphylaxis in patients with and without a penicillin allergy label: A cross-sectional study"
Summary published April 22, 2024
