ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 181 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Inpatient Penicillin Allergy Delabeling Pilot Project at University Hospitals-Rainbow Babies and Children's Hospital in Cleveland, Ohio
Investigation of Cross-allergies Between Cefazolin and Amoxicillin With Skin Tests and Provocation Test
Who cites it
181 citing papers in PubMed, 4 syntheses or guidelines pooled it, 447 citations in OpenAlex.
- Pooled it
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- Assessment of the Frequency of Dual Allergy to Penicillins and Cefazolin: A Systematic Review and Meta-analysis.JAMA surgery · 2021Pooled it
- Antibiotic prophylaxis in primary and revision shoulder replacement: a systematic review.BMC musculoskeletal disorders · 2020Pooled it
- The Pragmatic Removal of Penicillin Allergy Electronic Health Record Labels (PROPEL) Trial: A Randomized Clinical Trial.The journal of allergy and clinical immunology. In practice · 2025Trial
- Randomized Multicenter Trial for the Validation of an Easy-to-Administer Algorithm to Define Penicillin Allergy Status in Sexually Transmitted Infection Clinic Outpatients.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- Trial
- Antibiotic Stewardship Interventions Improve Choice of Antibiotic Prophylaxis in Total Joint Arthroplasty in Patients with Reported Penicillin Allergies.Clinical orthopaedics and related research · 2021Trial
- Improving surgical antimicrobial prophylaxis in patients with a penicillin allergy label: a quality improvement study.BMJ open quality · 2026Article
- Infection-embedded penicillin allergy de-labelling delivers immediate antimicrobial stewardship gains in patients with active infection.JAC-antimicrobial resistance · 2026Article
- Penicillin Allergy Delabeling: Bridging the Evidence-Practice Gap in Antimicrobial Stewardship.Journal of general internal medicine · 2026Review
- Antibiotics in Hand Surgery: Guidelines and Review.Journal of hand surgery global online · 2026Review
- Delabeling penicillin allergies in plastic and reconstructive surgery: Cefazolin as the cornerstone for antibiotic prophylaxis.JPRAS open · 2026Review
- Epidemiology of penicillin allergy labels in a general Swedish population.The journal of allergy and clinical immunology. Global · 2026Article
- Peri-operative allergy: continuing to navigate uncertainty.Anaesthesia · 2026Article
- Self-Reported Penicillin Allergy, Alternative Antibiotics, and Implant Outcomes: A Retrospective Study.Clinical implant dentistry and related research · 2026Article
- Implementing an Evidence-Based Guideline to Improve Perioperative Antimicrobial Prophylaxis Quality Among Patients With Penicillin Allergy Labels.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026Article
- Attitudes of caregivers of children labeled with drug allergy after delabeling by provocation tests.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Article
- Cephalosporin use and patient outcomes following removal of penicillin-cephalosporin cross-reactivity alerts from the electronic health record.Antimicrobial agents and chemotherapy · 2026Observational
- Penicillin allergy labels increase risks of MRSA colonization, surgical site infections, and mortality.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Article
121 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
Background: A reported penicillin allergy may compromise receipt of recommended antibiotic prophylaxis intended to prevent surgical site infections (SSIs). Most patients with a reported penicillin allergy are not allergic. We determined the impact of a reported penicillin allergy on the development of SSIs. Methods: In this retrospective cohort study of Massachusetts General Hospital hip arthroplasty, knee arthroplasty, hysterectomy, colon surgery, and coronary artery bypass grafting patients from 2010 to 2014, we compared patients with and without a reported penicillin allergy. The primary outcome was an SSI, as defined by the Centers for Disease Control and Prevention's National Healthcare Safety Network. The secondary outcome was perioperative antibiotic use. Results: Of 8385 patients who underwent 9004 procedures, 922 (11%) reported a penicillin allergy, and 241 (2.7%) had an SSI. In multivariable logistic regression, patients reporting a penicillin allergy had increased odds (adjusted odds ratio, 1.51; 95% confidence interval, 1.02-2.22) of SSI. Penicillin allergy reporters were administered less cefazolin (12% vs 92%; P < .001) and more clindamycin (49% vs 3%; P < .001), vancomycin (35% vs 3%; P < .001), and gentamicin (24% vs 3%; P < .001) compared with those without a reported penicillin allergy. The increased SSI risk was entirely mediated by the patients' receipt of an alternative perioperative antibiotic; between 112 and 124 patients with reported penicillin allergy would need allergy evaluation to prevent 1 SSI. Conclusions: Patients with a reported penicillin allergy had a 50% increased odds of SSI, attributable to the receipt of second-line perioperative antibiotics. Clarification of penicillin allergies as part of routine preoperative care may decrease SSI risk.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.