OCT 09, 2017 12:02 PM PDT

Penicillin Allergy Dangerous During Surgery

WRITTEN BY: Kara Marker

People who report a penicillin allergy before undergoing the simplest of surgical procedures are in danger of developing a surgical site infection. These types of infections increase a patient’s risk of death, even if they were just in surgery for a knee replacement. The kicker? A large majority of people who report a penicillin allergy can actually safely receive the antibiotic.

"We already know that more than 95 percent of patients who believe they have penicillin allergy can actually tolerate the drug, which indicates that preoperative penicillin evaluation could effectively reduce surgical site infections in these patients,” explained lead and corresponding author Kimberly Blumenthal, MD, MSc.

Blumenthal and others from Massachusetts General Hospital were the first to examine reported penicillin allergies in the context of surgical site infections.

Penicillin is a beta-lactam antibiotic, is widely used to treat infections, and includes penicillin derivatives, cephalosporins, and monobactams. Penicillin allergies are the most commonly reported drug allergy, but a 2010 found that they are rarer than people think: “True drug allergy, which is IgE-mediated, accounts for very few of all reported adverse drug reactions.”

Although some people might once experience an allergic reaction to penicillin, 90 percent of people will lose sensitivity over time, eventually becoming able to be treated safely with the drug.

But when medical records note “penicillin allergy,” doctors use alternative antibiotics to prevent surgical site infections. Current guidelines for people with penicillin allergies recommend avoiding cefazolin, a first-generation cephalosporin antibiotic and the gold standard for protection against surgical site infections. Instead, their options include clindamycin, vancomycin, and gentamicin, which are less effective at preventing surgical site infections and can take longer to become effective.

The team from MGH analyzed medical records of nearly 8,400 surgical patients. Eleven percent reported a penicillin allergy in their medical record, a value which mirrors the percentage of people from the larger population who report a penicillin allergy. In total, 241 total patients developed a surgical site infection. Those with a reported penicillin allergy were 50 percent more likely to succumb than those without.

This risk relationship is independent of age, sex, race, type and duration of surgery, and it is directly associated with the alternative type of antibiotics used as a result of the reported allergy. Researchers from the study note than an overwhelming majority of people with reported penicillin allergies “could have safely received standard testing for penicillin allergies.”

"We hope our findings spark reconsideration of the language about penicillin allergy testing in the national guidelines,” explained senior author Erica Shenoy, MD, PhD. “In the meantime, I would recommend that any patients with a history of allergy to penicillin or to cephalosporins - the antibiotic class that includes cefazolin - who are scheduled for surgery to ask their doctor whether an antibiotic would be needed and, if so, discuss a referral for an allergy evaluation in advance to increase their chances of getting the most effective antibiotic."

The present study was published in the journal Clinical Infectious Diseases.

Sources: Journal of Advanced Pharmaceutical Technology & Research, American College of Allergy, Asthma, & Immunology, Massachusetts General Hospital

About the Author
  • I am a scientific journalist and enthusiast, especially in the realm of biomedicine. I am passionate about conveying the truth in scientific phenomena and subsequently improving health and public awareness. Sometimes scientific research needs a translator to effectively communicate the scientific jargon present in significant findings. I plan to be that translating communicator, and I hope to decrease the spread of misrepresented scientific phenomena! Check out my science blog: ScienceKara.com.
You May Also Like
SEP 17, 2019
Immunology
SEP 17, 2019
When a Virus Infects Bacteria
Researchers have used P. aeruginosa as a 'model system' for understanding how bacteria's interactions with viruses may affect human health....
SEP 17, 2019
Drug Discovery
SEP 17, 2019
Combination Therapeutic Effective for Leishmaniasis and HIV Patients
In a study published in PLOS Neglected Diseases, a special combination therapy has been proven for efficacy in cases of coinfection with Visceral leishmani...
SEP 17, 2019
Immunology
SEP 17, 2019
Graphene and Health Impacts
The Graphene Flagship project is a dedicated Work Package studying the impact of graphene and related materials on health, as well as their environmental impact....
SEP 17, 2019
Immunology
SEP 17, 2019
Fecal Transplant improves ASD
Our understanding of the brain-gut connection is increasing by the day. Individuals with autism spectrum disorder (ASD) also experience gastrointestinal sy...
SEP 17, 2019
Cell & Molecular Biology
SEP 17, 2019
Understanding and Treating the Mechanisms That Drive Rheumatoid Arthritis
In RA, cells of the immune system mistakenly attack the joints, and cause the painful inflammation that is a hallmark of the disease....
SEP 17, 2019
Health & Medicine
SEP 17, 2019
Diagnosis and Treatment of Neurosarcoidosis
Sarcoidosis is a multisystem inflammatory disease characterized by the formation of non-caseating granulomas in the affected organs. The majority of p...
Loading Comments...