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Variability of surgical prophylaxis in penicillin-allergic children

David F Butler1, Brian R Lee1, Sarah Suppes2

  • 11Department of Pediatrics,Children's Mercy Hospital,Kansas City,Missouri.

Infection Control and Hospital Epidemiology
|December 12, 2018
PubMed

Insights

Penicillin allergy labeling impacts surgical antibiotic choices. Broader-spectrum antibiotics were more frequent in labeled cases, increasing the risk of adverse drug events during surgery.

Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Surgical Sciences

Background:

  • Surgical antibiotic prophylaxis is crucial for preventing infections.
  • Accurate penicillin allergy labeling is essential for appropriate antibiotic selection.
  • Adverse drug reactions (ADRs) can complicate perioperative care.

Purpose of the Study:

  • To evaluate the impact of penicillin adverse drug reaction (ADR) labeling on the selection of surgical antibiotic prophylaxis.
  • To assess the association between penicillin ADR labeling and the use of broad-spectrum antibiotics.
  • To determine the relationship between antibiotic prophylaxis choices and perioperative adverse drug events.

Main Methods:

  • Retrospective analysis of patient data.
  • Evaluation of antibiotic prescribing patterns based on penicillin ADR status.
  • Comparison of adverse drug event rates between groups.

Main Results:

  • Cefazolin use was significantly higher in patients without penicillin ADR labeling (86%) compared to those with labeling (28%).
  • Broad-spectrum antibiotic administration was more prevalent in patients with penicillin ADR labeling.
  • Penicillin ADR-positive cases showed a higher incidence of perioperative adverse drug events.

Conclusions:

  • Penicillin ADR labeling influences the choice of surgical antibiotic prophylaxis, often leading to broader-spectrum agent use.
  • Increased use of broad-spectrum antibiotics in penicillin-allergic patients may be associated with a higher risk of perioperative adverse drug events.
  • Re-evaluation of antibiotic stewardship protocols for patients with penicillin allergy is warranted.

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