Evidence map›Paper›PMID 42138376›Full record

Observational studyAntimicrobial agents and chemotherapy2026

Cephalosporin use and patient outcomes following removal of penicillin-cephalosporin cross-reactivity alerts from the electronic health record.

Alicia Zimmer, Jessica Zagari, Paulina Sudnik, Alexandra Yamshchikov, Samia Lopa, Sarah Spitznogle, William DePasquale, Devin Donnelly, David Dobrzynski, Jessica Stern and 2 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Antimicrobial agents and chemotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Alicia Zimmer *Department of Pharmacy, University of Rochester Medical Center, Highland Hospital, Rochester, New York, USA.
Jessica Zagari *Department of Pharmacy, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York, USA.ORCID 0000-0003-1458-1646
Paulina SudnikDepartment of Medicine, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York, USA.
Alexandra YamshchikovDepartment of Medicine, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York, USA.
Samia LopaDepartment of Medicine Biostatistical Shared Resource, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.ORCID 0000-0002-8475-9262
Sarah SpitznogleDepartment of Pharmacy, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York, USA.
William DePasqualeDepartment of Pharmacy, University of Rochester Medical Center, Highland Hospital, Rochester, New York, USA.
Devin DonnellyDepartment of Pharmacy, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York, USA.
David DobrzynskiDepartment of Medicine, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York, USA.
Jessica SternDepartment of Medicine, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York, USA.
Stephanie ShulderDepartment of Pharmacy, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York, USA.
Katelyn S QuartuccioDepartment of Pharmacy, University of Rochester Medical Center, Highland Hospital, Rochester, New York, USA.ORCID 0000-0002-6658-9132

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Studies have shown there is minimal risk of cephalosporin cross-reactivity with penicillin (PCN), though avoidance in practice still occurs. Avoidance of cephalosporins due to reported PCN allergies can result in negative clinical outcomes. Removal of cross-reactivity alerts from the electronic health record (EHR) may increase cephalosporin utilization. The objective of this study was to evaluate cephalosporin utilization in those with documented intermediate-, high-, and severe-risk allergies following an EHR cross-reactivity alert removal. This was a retrospective, observational, pre-post review of patients with a documented intermediate-, high-, or severe-risk PCN allergy who received at least one dose of a systemic antibiotic for an indication in which a cephalosporin was first line. An EHR alert removal was implemented along with system-wide guideline updates and education. The primary outcome was the rate of cephalosporin utilization. Secondary outcomes included rates of PCN utilization, antibiotic adverse effects, and a composite of treatment failure. A total of 235 patients were included (pre = 118, post = 117). Intermediate-risk allergies made up a majority of the population (74%), with surgical site infection prophylaxis being the most common antibiotic indication (63%). Cephalosporin utilization significantly increased after alert removal (27% vs 67%,

Indexed as

Anti-Bacterial AgentsCephalosporinsDrug HypersensitivityPenicillinsAgedCross ReactionsElectronic Health RecordsFemaleHumansMaleMiddle AgedRetrospective StudiesSurgical Wound InfectionAnti-Bacterial AgentsCephalosporinsPenicillinsalertallergyanaphylaxisantibioticsantimicrobialscephalosporincross-reactivityelectronic health recordpenicillinpenicillin allergy

Identifiers

PMID42138376
PMCPMC13231902

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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.