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

Christie M Bertram; Michael Postelnick; Christian M Mancini; Xiaoqing Fu; Yuqing Zhang; Lucas T Schulz; Tanaya Bhowmick; Francesca Lee; Kimberly G Blumenthal

doi:10.1093/cid/ciaa1762

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

Clin Infect Dis. 2021 Jun 1;72(11):e872-e875. doi: 10.1093/cid/ciaa1762.

Authors

Christie M Bertram^{1

2}, Michael Postelnick¹, Christian M Mancini^{3

4}, Xiaoqing Fu^{3

4}, Yuqing Zhang^{4

5

6}, Lucas T Schulz⁷, Tanaya Bhowmick⁸, Francesca Lee^{9

10}, Kimberly G Blumenthal^{3

4

5}

Affiliations

¹ Northwestern Memorial Hospital, Department of Pharmacy, Chicago, Illinois, USA.
² Department of Pharmacy Practice, College of Pharmacy, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA.
³ Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁴ The Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁵ Harvard Medical School, Boston, Massachusetts, USA.
⁶ Clinical Epidemiology Research and Training, Boston University School of Medicine, Boston, Massachusetts, USA.
⁷ Department of Pharmacy, University of Wisconsin Health, Madison, Wisconsin, USA.
⁸ Division of Allergy, Immunology, and Infectious Diseases, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
⁹ Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
¹⁰ Division of Infectious Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

PMID: 33242095
DOI: 10.1093/cid/ciaa1762

Abstract

Alternative antibiotics for surgical prophylaxis are associated with increased adverse events and surgical site infection compared to cefazolin. In a sample of perioperative inpatients from 100 hospitals in the United States, cefazolin was 9-fold less likely to be used in patients with a documented β-lactam allergy whereas clindamycin was 45-fold more likely.

Keywords: allergy; antibiotic; surgical prophylaxis; β-lactam.

Published by Oxford University Press for the Infectious Diseases Society of America 2020.

MeSH terms

Anti-Bacterial Agents / therapeutic use
Antibiotic Prophylaxis
Cross-Sectional Studies
Documentation
Drug Hypersensitivity*
Humans
Retrospective Studies
Surgical Wound Infection / drug therapy
United States
beta-Lactams* / therapeutic use

Substances

Anti-Bacterial Agents
beta-Lactams