Penicillin allergy labels drive perioperative prophylactic antibiotic selection in orthopedic procedures

doi:10.1016/j.jaip.2020.07.007

. 2020 Nov-Dec;8(10):3634-3636.e1.

doi: 10.1016/j.jaip.2020.07.007. Epub 2020 Jul 18.

Penicillin allergy labels drive perioperative prophylactic antibiotic selection in orthopedic procedures

David T Coleman¹, Cosby A Stone Jr¹, Wei-Qi Wei², Elizabeth J Phillips³

Affiliations

¹ Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn.
² Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tenn.
³ Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn; Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tenn; Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tenn; Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, WA, Australia. Electronic address: elizabeth.j.phillips@vanderbilt.edu.

PMID: 32693215
PMCID: PMC7655694
DOI: 10.1016/j.jaip.2020.07.007

Penicillin allergy labels drive perioperative prophylactic antibiotic selection in orthopedic procedures

David T Coleman et al. J Allergy Clin Immunol Pract. 2020 Nov-Dec.

. 2020 Nov-Dec;8(10):3634-3636.e1.

doi: 10.1016/j.jaip.2020.07.007. Epub 2020 Jul 18.

Authors

David T Coleman¹, Cosby A Stone Jr¹, Wei-Qi Wei², Elizabeth J Phillips³

Affiliations

¹ Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn.
² Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tenn.
³ Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn; Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tenn; Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tenn; Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, WA, Australia. Electronic address: elizabeth.j.phillips@vanderbilt.edu.

PMID: 32693215
PMCID: PMC7655694
DOI: 10.1016/j.jaip.2020.07.007

No abstract available

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Conflict of interest statement

Conflicts of Interest: The authors declare no conflict of interest directly related to this manuscript

Figures

**Figure 1:. Percentage of orthopedic surgeries utilizing cefazolin, clindamycin, and vancomycin, by penicillin allergy status.**
Patients with a penicillin allergy label were less likely to receive cefazolin***, and more likely to receive clindamycin***compared to patients with no penicillin allergy label. There was no difference in receipt of vancomycin (***P<0.0005, NS= not significant).

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References

1. Macy E. Penicillin and beta-lactam allergy: epidemiology and diagnosis. Curr Allergy Asthma Rep 2014; 14:476. - PubMed
1. Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin “allergy” in hospitalized patients: A cohort study. J Allergy Clin Immunol 2014; 133:790–6. - PubMed
1. Blumenthal K, Ryan E, Li Y, Lee H, Kuhlen J, Shenoy E. The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk. Clin Infect Dis 2018; 66:329–36. - PMC - PubMed
1. Kheir M, Tan T, Azboy I, Tan D, Parvizi J. Vancomycin Prophylaxis for Total Joint Arthroplasty: Incorrectly Dosed and Has a Higher Rate of Periprosthetic Infection Than Cefazolin. Clin Orthop Relat Res 2017; 475:1767–74. - PMC - PubMed
1. Wyles C, Hevesi M, Osmon D, Park M, Habermann E, Lewallen D, et al. 2019 John Charnley Award: Increased risk of prosthetic joint infection following primary total knee and hip arthroplasty with the use of alternative antibiotics to cefazolin: the value of allergy testing for antibiotic prophylaxis. Bone Joint J 2019; 101-B:9–15. - PubMed

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[1] Macy E. Penicillin and beta-lactam allergy: epidemiology and diagnosis. Curr Allergy Asthma Rep 2014; 14:476. - PubMed

[2] Macy E. Penicillin and beta-lactam allergy: epidemiology and diagnosis. Curr Allergy Asthma Rep 2014; 14:476. - PubMed

[3] Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin “allergy” in hospitalized patients: A cohort study. J Allergy Clin Immunol 2014; 133:790–6. - PubMed

[4] Macy E, Contreras R. Health care use and serious infection prevalence associated with penicillin “allergy” in hospitalized patients: A cohort study. J Allergy Clin Immunol 2014; 133:790–6. - PubMed

[5] Blumenthal K, Ryan E, Li Y, Lee H, Kuhlen J, Shenoy E. The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk. Clin Infect Dis 2018; 66:329–36. - PMC - PubMed

[6] Blumenthal K, Ryan E, Li Y, Lee H, Kuhlen J, Shenoy E. The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk. Clin Infect Dis 2018; 66:329–36. - PMC - PubMed

[7] Kheir M, Tan T, Azboy I, Tan D, Parvizi J. Vancomycin Prophylaxis for Total Joint Arthroplasty: Incorrectly Dosed and Has a Higher Rate of Periprosthetic Infection Than Cefazolin. Clin Orthop Relat Res 2017; 475:1767–74. - PMC - PubMed

[8] Kheir M, Tan T, Azboy I, Tan D, Parvizi J. Vancomycin Prophylaxis for Total Joint Arthroplasty: Incorrectly Dosed and Has a Higher Rate of Periprosthetic Infection Than Cefazolin. Clin Orthop Relat Res 2017; 475:1767–74. - PMC - PubMed

[9] Wyles C, Hevesi M, Osmon D, Park M, Habermann E, Lewallen D, et al. 2019 John Charnley Award: Increased risk of prosthetic joint infection following primary total knee and hip arthroplasty with the use of alternative antibiotics to cefazolin: the value of allergy testing for antibiotic prophylaxis. Bone Joint J 2019; 101-B:9–15. - PubMed

[10] Wyles C, Hevesi M, Osmon D, Park M, Habermann E, Lewallen D, et al. 2019 John Charnley Award: Increased risk of prosthetic joint infection following primary total knee and hip arthroplasty with the use of alternative antibiotics to cefazolin: the value of allergy testing for antibiotic prophylaxis. Bone Joint J 2019; 101-B:9–15. - PubMed

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Penicillin allergy labels drive perioperative prophylactic antibiotic selection in orthopedic procedures

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Penicillin allergy labels drive perioperative prophylactic antibiotic selection in orthopedic procedures

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