ArticleJournal of clinical anesthesia2024
Examining cefazolin utilization and perioperative anaphylaxis in patients with and without a penicillin allergy label: A cross-sectional study.
Article in Journal of clinical anesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Antibiotics in Hand Surgery: Guidelines and Review.Journal of hand surgery global online · 2026Review
- Implementing an Evidence-Based Guideline to Improve Perioperative Antimicrobial Prophylaxis Quality Among Patients With Penicillin Allergy Labels.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026Article
- Perioperative antibiotic prophylaxis in robotic-assisted ventral hernia repair: a propensity score-matched analysis.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Perioperative cefazolin prophylaxis in patients with β-lactam allergy: a quality improvement project.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026Article
- Cefazolin as an alternative in patients with a history of penicillin or β-lactam antibiotic allergy: A case overview.Allergologie select · 2026Article
- Optimizing perioperative antibiotic prophylaxis: a prospective cohort study on cefazolin utilization in surgical patients with penicillin allergy labels.Perioperative medicine (London, England) · 2025Article
- Review
- 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
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Authors and funding
9 authors.
Funding
Abstract
STUDY
objectiveTo compare the occurrence of cefazolin perioperative anaphylaxis (POA) in patients with and without a penicillin allergy label (PAL) to determine whether the prevalence of cefazolin POA differs based on the presence of a PAL.
designCross-sectional study.
settingA large U.S. healthcare system in the Baltimore-D.C. region, July 2017 to July 2020. PATIENTS: 112,817 surgical encounters across inpatient and outpatient settings in various specialties, involving 90,089 patients. Of these, 4876 (4.3%) encounters had a PAL.
interventionsPerioperative cefazolin administration within 4 h before surgery to 4 h after the procedure began. MEASUREMENTS: The primary outcome was cefazolin POA in patients with and without PALs. Potential POA cases were identified based on tryptase orders or diphenhydramine administrations within the initial cefazolin administration to 6 h postoperatively. Verification included two validation steps. The first checked for hypersensitivity reaction (HSR) documentation, and the second, led by Allergy specialists, identified POA and the probable culprit. The secondary outcome looked at cefazolin use trends in patients with a PAL, stratified by setting and specialty. MAIN
resultsOf 112,817 encounters, 1421 (1.3%) had possible cefazolin HSRs. Of these, 22 (1.5%) had POA, resulting in a 0.02% prevalence. Of these, 13 (59.1%) were linked to cefazolin and 9 (40.9%) attributed to other drugs. Only one cefazolin POA case had a PAL, indicating no significant difference in cefazolin POA prevalence between patients with and without PALs (p = 0.437). Perioperative cefazolin use in patients with PALs steadily increased from 2.6% to 6.0% between 2017 and 2020, specifically in academic settings.
conclusionsThe prevalence of cefazolin POA does not exhibit significant differences between patients with and without PALs, and notably, the incidence remains remarkably low. Based on these findings, it is advisable to view cefazolin as an acceptable choice for prophylaxis in patients carrying a PAL.
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