Observational studyDeutsches Arzteblatt international2025
Single-Shot Perioperative Antibiotic Prophylaxis in Patients With a History of Penicillin Allergy: An Algorithm for the Safe Administration of Cefuroxime.
Observational study in Deutsches Arzteblatt international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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Who cites it
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with a history of penicillin allergy are often given a less suitable non-ß-lactam antibiotic as single-shot peri - operative prophylaxis, for fear of an allergic reaction. This endangers these patients' health, particularly exposing them to a higher risk of wound infection.
methodsWith the aid of a quality management tool and three iterative "Plan-Do-Study-Act (PDSA)" cycles, we developed and evaluated an algorithm for the safe administration of single-shot cefuroxime as perioperative antibiotic prophylaxis in patients with a history of penicillin allergy.
results6045 anesthesia records were evaluated in three PDSA cycles. 340 patients (5.6%) reported a penicillin allergy in their medical history, and 166 of these patients (2.7% of the total) received perioperative antibiotic prophylaxis: 156 (2.5%) patients were given cefuroxime, and 7 (0.1%) were given another antibiotic, mainly for surgery-specific reasons. In two cases, clindamycin was given despite the algorithm; these two led to quality improvement measures, so that in the third PDSA cycle, over an observation period of 6 months, no patient was denied cefuroxime because they had a penicillin allergy. No allergic reactions to cefuroxime were observed.
conclusionAs part of a quality management measure, we developed an algorithm that allowed cefuroxime to be given as single-shot perioperative antibiotic prophylaxis to almost all patients with a history of penicillin allergy. Only patients with severe T-cell-mediated reactions should not be given ß-lactam antibiotics.
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