![]() While most of the observed difference in β-lactam prescribing can likely be attributed to cefazolin not sharing a similar R-group side chain with other β-lactams (and thus overwhelmingly being the most frequently recommended therapy for surgical prophylaxis in patients with documented allergies to other β-lactams), the chart developed in this work (see page 4 of the Supplementary Data) can be of great benefit to antimicrobial stewards in clarifying β-lactam allergy risk to prescribers at their facility. ![]() Thirty-day readmissions were slightly lower in the intervention cohort no other differences in clinical outcomes were observed. Nine patients total (six receiving alternative therapy and three receiving β-lactam therapy) had likely antibiotic-related allergic reactions only one of the β-lactam allergies was a type I hypersensitivity reaction (the other two were mild). Cefazolin was used 98.2% of the time when β-lactams were administered. The authors noted that from January 2012 to September 2014, 950 of 1,119 (84.9%) patients with documented β-lactam allergies received non-β-lactam agents for surgical prophylaxis, which was reduced to 164 of 1,089 (15.1%) patients from July 2016 to September 2018 (P <. Usage of this chart was incorporated into surgical prophylaxis guidance starting in 2014 at their 537-bed community teaching hospital. Penicillin allergies are reported by 8 to 15 of the US population, but up to 95 of these allergies do not correspond to a true allergy when tested. The type of allergic reaction and the specific agent involved are important, as most type I hypersensitivity reactions involve R-group side chains of the β-lactam ring, properties of which differ from one agent to another and thus influence allergy cross-reactivity.Īuthors of a recent study in Clinical Infectious Diseases compiled side-chain-based cross-reactivity data into a detailed chart that recommends strategies for assessing risk of allergic reaction based on the agent to be prescribed and the agent to which a patient may have had a prior allergic reaction. Utilization of an Antibiotic Side-chain-based Cross-reactivity Chart to Improve Surgical ProphylaxisĬlarification of penicillin allergy status has emerged recently as an important antimicrobial stewardship topic, as it can lead to improved prescribing practices. ![]() Medical Education Community of Practice.Fellows-In-Training Career & Education Center.myIDSA Practice Managers Community Opt-in Form.Antimicrobial Stewardship Centers of Excellence Program. ![]()
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