Association of β-Lactam Allergy Documentation and Prophylactic Antibiotic Use in Surgery: A National Cross-Sectional...

Area of Science:

• Infectious Diseases
• Clinical Pharmacy
• Surgical Outcomes

Background:

• Cefazolin is a preferred antibiotic for surgical prophylaxis.
• Alternative antibiotics may be associated with increased adverse events and surgical site infections.
• Beta-lactam allergy is a common reason for alternative antibiotic selection.

Purpose of the Study:

• To compare the use of cefazolin versus alternative antibiotics for surgical prophylaxis.
• To investigate the association between beta-lactam allergy and antibiotic selection.
• To evaluate the impact of antibiotic choice on adverse events and surgical site infections.

Main Methods:

• Retrospective analysis of perioperative inpatients from 100 US hospitals.
• Comparison of cefazolin use versus alternative antibiotics in patients with and without beta-lactam allergy.
• Assessment of adverse events and surgical site infection rates.

Main Results:

• Alternative antibiotics were linked to higher rates of adverse events and surgical site infections than cefazolin.
• Cefazolin was 9-fold less likely to be used in patients with a documented beta-lactam allergy.
• Clindamycin was 45-fold more likely to be used in patients with a documented beta-lactam allergy.

Conclusions:

• Current antibiotic prophylaxis practices may not align with optimal choices for patients with beta-lactam allergies.
• Over-reliance on alternatives like clindamycin in beta-lactam allergic patients may increase infectious complications.
• Further research is needed to optimize antibiotic selection for surgical prophylaxis in allergic patients.