Evaluation of Antibiotic Allergies in Surgical Patients

Orthop Nurs. 2021 Jul-Aug;40(4):248-254. doi: 10.1097/NOR.0000000000000776.

Abstract

Antibiotic administration in the perioperative period is the foundation of preventing surgical site infections. β-Lactam antibiotics, notably the first-generation cephalosporin cefazolin, are the drugs of choice for this indication. However, reported antibiotic allergies often result in the use of suboptimal alternative agents that can lead to an increased risk of infection and adverse effects. A comprehensive allergy history and risk stratification should be completed preoperatively to determine whether or not a patient can be rechallenged with a β-lactam antibiotic and what testing may be necessary prior to administration. Nursing staff can play a critical role in understanding the implications and management of reported antibiotic allergies in surgical patients in order to optimize patient care.

MeSH terms

  • Aminoglycosides / administration & dosage
  • Aminoglycosides / adverse effects
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Aztreonam / administration & dosage
  • Aztreonam / adverse effects
  • Cefazolin / administration & dosage
  • Cefazolin / adverse effects
  • Clindamycin / administration & dosage
  • Clindamycin / adverse effects
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / immunology
  • Humans
  • Hypersensitivity / diagnosis*
  • Retrospective Studies
  • Vancomycin / administration & dosage
  • Vancomycin / adverse effects
  • beta-Lactams / administration & dosage
  • beta-Lactams / adverse effects

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • beta-Lactams
  • Clindamycin
  • Vancomycin
  • Aztreonam
  • Cefazolin