Reported Penicillin Allergy Ups Surgical Site Infection Risk

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Increased risk of SSI was mediated by patients' receipt of alternative perioperative antibiotic.
Increased risk of SSI was mediated by patients' receipt of alternative perioperative antibiotic.

(HealthDay News) -- Patients with penicillin allergy have increased odds of surgical site infection (SSI), according to a study published online Oct. 9 in Clinical Infectious Diseases to coincide with presentation at IDWeek, the combined annual meeting of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society, held Oct. 4 to 8 in San Diego.

Kimberley G. Blumenthal, MD, from Massachusetts General Hospital in Boston, and colleagues conducted a retrospective cohort study involving 8385 patients who underwent 9004 procedures from 2010 to 2014.

A total of 11% of patients reported a penicillin allergy, and 2.7% had an SSI. The researchers found that patients reporting a penicillin allergy had increased odds of SSI in multivariable logistic regression (adjusted odds ratio, 1.51). Compared with patients without a reported penicillin allergy, those who reported penicillin allergy were administered less cefazolin and more clindamycin, vancomycin, and gentamicin. The increased risk of SSI was mediated entirely by the patients' receipt of an alternative perioperative antibiotic. To prevent one SSI, between 112 and 124 patients with reported penicillin allergy would need allergy evaluation.

"Patients with a reported penicillin allergy had a 50% increased odds of SSI, attributable to the receipt of second-line perioperative antibiotics," the authors write. "Clarification of penicillin allergies as part of routine preoperative care may decrease SSI risk."

Reference

Blumenthal KG, Ryan EE, Li Y, Lee H, Kuhlen JL, and Shenoy ES. The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk. Clin Infect Dis. doi: 10.1093/cid/cix794

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