ArticleAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology2020
Preoperative penicillin allergy testing in patients undergoing cardiac surgery.
Article in Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 35 citations in OpenAlex.
- β-Lactam vs Non-β-Lactam Antimicrobial Prophylaxis and Surgical Site Infection.JAMA network open · 2025Article
- 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
- Penicillin allergy delabeling in long-term care facilities: if not now, then when?Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Quality corner: Safely using cephalosporins in almost all patients with penicillin allergies: Mini-review and suggested protocol to improve efficacy and surgical outcomes.Gynecologic oncology reports · 2024Review
- Examining cefazolin utilization and perioperative anaphylaxis in patients with and without a penicillin allergy label: A cross-sectional study.Journal of clinical anesthesia · 2024Article
- Utility of beta-lactam allergy assessment in patients receiving vancomycin for surgical prophylaxis.Surgery in practice and science · 2024Article
- Management of Penicillin Allergy in the Perioperative Setting.Antibiotics (Basel, Switzerland) · 2024Review
- Penicillin allergy delabeling: Opportunities for implementation and dissemination.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2023Review
- Management of the Pregnant Patient with Beta-Lactam Allergy.Current allergy and asthma reports · 2023Review
- The Impact of Reported β-Lactam Allergy on Clinical Outcomes and Antibiotic Use Among Solid Organ Transplant Recipients.Open forum infectious diseases · 2022Article
- Drug Allergy Delabeling Programs: Recent Strategies and Targeted Populations.Clinical reviews in allergy & immunology · 2022Review
- Association of β-Lactam Allergy Documentation and Prophylactic Antibiotic Use in Surgery: A National Cross-Sectional Study of Hospitalized Patients.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Breaking the Mold: Safely Delabeling Penicillin Allergies in Hospitalized Children.Hospital pediatrics · 2021Article
- Skin Testing for Penicillin Allergy: a Review of the Literature.Current allergy and asthma reports · 2021Review
- Penicillin Allergy Assessment in Pregnancy: Safety and Impact on Antibiotic Use.The journal of allergy and clinical immunology. In practice · 2021Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundCefazolin is a first-line prophylactic antibiotic used to prevent surgical site infections (SSIs) in cardiac surgery. Patients with a history of penicillin allergy often receive less effective second-line antibiotics, which is associated with an increased SSI risk.
objectiveTo describe the impact of preoperative penicillin allergy evaluation on perioperative cefazolin use in patients undergoing cardiac surgery.
methodsWe performed a retrospective cohort study of patients with a documented penicillin allergy who underwent cardiac surgery at the Massachusetts General Hospital from September 2015 to December 2018. We describe penicillin allergy evaluation assessment and outcomes. We evaluated the association between preoperative penicillin allergy evaluation and first-line perioperative antibiotic use using a multivariable logistic regression model.
resultsOf 3802 cardiac surgical patients, 510 (13%) had a documented penicillin allergy; 165 (33%) were referred to allergy and immunology practitioners. Of 160 patients (31%) who underwent penicillin allergy evaluation (ie, penicillin skin testing and, if results were negative, an amoxicillin challenge), 154 (97%) were found not to have a penicillin allergy. Patients who underwent preoperative penicillin allergy evaluation were more likely to receive the first-line perioperative antibiotic (92% vs 38%, P < .001). After adjusting for potential confounders, patients who underwent preoperative penicillin allergy evaluation had higher odds of first-line perioperative antibiotic use (adjusted odds ratio, 26.6; 95% CI, 12.8-55.2).
conclusionIntegrating penicillin allergy evaluation into routine preoperative care ensured that almost all evaluated patients undergoing cardiac surgery received first-line antibiotic prophylaxis, a critical component of SSI risk reduction. Further efforts are needed to increase access to preoperative allergy evaluation.
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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.