ArticleSurgical endoscopy2020
The association of penicillin allergy with outcomes after open ventral hernia repair.
Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Assessment of the Frequency of Dual Allergy to Penicillins and Cefazolin: A Systematic Review and Meta-analysis.JAMA surgery · 2021Pooled it
- Cost analysis of research publications and quality improvement initiatives at a tertiary hernia center over four years.Surgical endoscopy · 2026Article
- National expert consensus on the management of antibiotic prophylaxis in surgical patients with a penicillin allergy label based on the Delphi method.JAC-antimicrobial resistance · 2025Article
- The impact of a closing protocol on wound morbidity in abdominal wall reconstruction with mesh.Surgical endoscopy · 2025Article
- A rapid literature review of the impact of penicillin allergy on antibiotic resistance.JAC-antimicrobial resistance · 2025Review
- Concurrent Panniculectomy With Abdominal Wall Reconstruction: A Propensity-scored Matched Study of Quality Improvement Outcomes.Plastic and reconstructive surgery. Global open · 2024Article
- Diagnosis and Treatment of Perioperative Allergic Complications: A Practical Review.Plastic and reconstructive surgery. Global open · 2024Review
- Impact of penicillin allergy labels on surgical site infections in a large UK cohort of gastrointestinal surgery patients.JAC-antimicrobial resistance · 2024Article
- Prevalence of reported penicillin allergy and associations with perioperative complications, length of stay, and cost in patients undergoing elective cancer surgery.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Building a Center for Abdominal Core Health: The Importance of a Holistic Multidisciplinary Approach.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUp to 11% of patients report a penicillin allergy (PA), with 1-2% demonstrating a true IgE mediated allergy upon testing. PA patients often receive non-beta-lactam antibiotic surgical prophylaxis (non-BLP). This study evaluates the relationship of PA to outcomes after open ventral hernia repair (OVHR).
methodsA prospective institutional database was queried for patients undergoing OVHR. Demographics, operative characteristics, and outcomes were evaluated by the reported PA and the administration of beta-lactam prophylaxis (BLP).
resultsAllergy histories were reviewed in 1178 patients. PA was reported in 21.6% of patients, with 55.5% reporting rash or hives, 15.0% airway compromise or anaphylaxis, and 29.5% no specific reaction. BLP was administered to 76.3% of patients, including 22.1% of PA patients and 89.9% of patients without PA. PA patients were more often female (64.6% PA patients vs. 56% non-PA, p = 0.01), with higher rates of chronic steroids, MRSA, anxiety, asthma, COPD, chronic pain, and sleep apnea (p < 0.03 all values). PA patients had higher rates of contaminated cases, including mesh infection and fistula. Of the 683 clean cases, 82.1% received BLP. Of the 117 clean contaminated cases (CDC wound class 2), 82.9% received BLP, which was associated with reduced long-term readmission for hernia complications (21.5 vs. 55%, p = 0.002, OR 0.27, CI 0.09-0.83). In the 120 CDC wound class 3 and 4 patients, 65.8% received BLP. In multivariate analysis, BLP was associated with lower rates of reoperation (OR 0.31, CI 0.12-0.76) and recurrence (OR 0.32, CI 0.11-0.86). BLP was given to 22.1% of the PA patients with no adverse reactions noted.
conclusionPA patients had more comorbidities and complex ventral hernias. When controlling for contamination and MRSA history, BLP is associated with improved outcomes particularly in contaminated cases. PA may be a risk factor for patient complexity, and further studies are warranted to determine if allergy testing can be warranted in known or anticipated contaminated cases.
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