Journal article
Penicillin allergy and surgical prophylaxis: Cephalosporin cross-reactivity risk in a pediatric tertiary care center
Journal of pediatric surgery, Vol.50(5), pp.856-859
05/01/2015
DOI: 10.1016/j.jpedsurg.2014.10.048
PMID: 25783308
Abstract
First generation cephalosporins are commonly used as antibiotic prophylaxis prior to surgery. Patients labeled as penicillin-allergic are often precluded from receiving cephalosporins because of an allergic cross-reactivity. The aims of this study were to evaluate the clinical practice for surgical prophylaxis at Nationwide Children's Hospital and to determine the incidence of adverse effects and allergic reactions when using cephalosporins in patients labeled as penicillin-allergic.
A retrospective chart review was performed to identify patients who were allergic to penicillin, penicillin antibiotic family, who required surgical treatment for an existing medical condition, and received an antibiotic to prevent surgical site infection.
Five hundred thirteen penicillin-allergic patients were identified, encompassing 624 surgical cases. Cephalosporins were administered in 153 cases (24.5%) with cefazolin used 83% of the time. Only one documented case of nonanaphylactic reaction was reported. Clindamycin was the most common cephalosporin substitute (n=387), and the reported adverse reaction rate was 1.5%. No cases of anaphylaxis were documented.
Our data suggest that the administration of cephalosporins for surgical prophylaxis following induction of anesthesia in a patient with a known or reported penicillin-allergy appears appropriate and results in a lower adverse event rate that when clindamycin is administered.
Details
- Title: Subtitle
- Penicillin allergy and surgical prophylaxis: Cephalosporin cross-reactivity risk in a pediatric tertiary care center
- Creators
- Ralph J. Beltran - Nationwide Children's HospitalHiromi Kako - Nationwide Children's HospitalThomas Chovanec - Nationwide Children's HospitalArchana Ramesh - Nationwide Children's HospitalBruno Bissonnette - Nationwide Children's HospitalJoseph D. Tobias - Nationwide Children's Hospital
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric surgery, Vol.50(5), pp.856-859
- DOI
- 10.1016/j.jpedsurg.2014.10.048
- PMID
- 25783308
- NLM abbreviation
- J Pediatr Surg
- ISSN
- 0022-3468
- eISSN
- 1531-5037
- Publisher
- Elsevier Inc
- Number of pages
- 4
- Language
- English
- Date published
- 05/01/2015
- Academic Unit
- Anesthesia
- Record Identifier
- 9985178667802771
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