Surgical Patients Allergic to Penicillin Have Another Safe Alternative

The antibiotic cefazolin is a safe alternative to prevent infection in most surgical patients who are allergic to penicillin, according to a new study.

Cefazolin is a type of antibiotic known as a cephalosporin. It’s the recommended antibiotic for most surgical procedures, but some doctors are reluctant to give it to patients with penicillin-allergies based on research from the 1960s and 1970s that found some might also be allergic to cephalosporins like cefazolin.

“Under current practice, the roughly 10% of U.S. patients reporting a penicillin allergy are less likely to receive cefazolin at the time of surgery and more likely to receive clindamycin or vancomycin, which increases their risk of developing a surgical infection,” said study co-author Dr. Kimberly Blumenthal. She is an investigator in the division of rheumatology, allergy and immunology at Massachusetts General Hospital, in Boston.

Of the more than 17 million surgeries performed in the United States each year, nearly 111,000 result in surgical site infections, according to the U.S. Centers for Disease Control and Prevention.

For the new study, the researchers analyzed 77 studies with a total 6,147 patients, and concluded that most surgical patients with a history of penicillin allergy can safely be given cefazolin instead of several less effective and more costly penicillin alternatives.

“Our study found that the frequency of dual allergies to penicillin and cefazolin was so small — 0.7% — that surgeons and anesthesiologists should feel confident giving cefazolin to nearly all patients with a penicillin allergy history,” Blumenthal concluded in a hospital news release.

The findings were published March 17 in JAMA Surgery.

“Avoidance of cefazolin based on 50-year-old data is unnecessary and, in many cases, ill-advised,” said study senior author Meghan Jeffres, of the University of Colorado School of Pharmacy, in Aurora.

“Not only is cefazolin safe for nearly all patients with penicillin allergy, but also, studies have shown that it’s well-tolerated and has the appropriate spectrum of activity against organisms commonly encountered in surgical site infections,” Jeffres added.

More information

The U.S. National Library of Medicine has more on cefazolin.

SOURCE: Massachusetts General Hospital, news release, March 17, 2021

Source: HealthDay