Further Evidence for Safety of Preoperative Cefazolin in Reported Penicillin-Allergic Patients

A growing body of evidence shows that penicillin allergy is not a risk factor for hypersensitivity to cefazolin (NEJM JW Gen Med May 1 2021 and JAMA Surg 2021; 156:e210021). Almost 10% of U.S. patients have reported penicillin allergies (although fewer than 10% with reported allergies are found to be truly allergic after skin testing or oral challenge). Patients with reported penicillin allergies who are given alternative preoperative antibiotics, such as vancomycin, clindamycin, or aztreonam, incur higher hospital costs and excess surgical-site and nosocomial infections.

Hospital records for 8770 patients with reported penicillin allergy who underwent surgery at a California academic medical center were reviewed. More than 80% of these pati…