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 07, 2019
Immunology
SEP 07, 2019
A New Way To Fight Severe Peanut Allergies
Dr. Sandra Lin explains how SLIT is currently being used to treat allergies other than peanuts.    Over 1 million U.S. children have an allergy t...
OCT 16, 2019
Health & Medicine
OCT 16, 2019
Study Links High Birth Weight to Risk of Allergies
Researchers from the University of Adelaide, Australia have linked the risk of developing childhood food allergies and eczema to heavier birth weight. The...
OCT 22, 2019
Cell & Molecular Biology
OCT 22, 2019
New RNA Observation Shows Previously Unkown Attachment to Sugar
Scientists in the Bertozzi at Staford University have published surprising observations of glycan sugars attached directly to RNA during glycosylation.&nbs...
OCT 29, 2019
Microbiology
OCT 29, 2019
Antibody Discovered That May be the Key to a Universal Flu Vaccine
Instead of designing a new flu vaccine every year, researchers have made a breakthrough that may lead to a single vaccine that protects against all strains....
DEC 17, 2019
Immunology
DEC 17, 2019
Increased Belly Fat with Aging Linked to Reduced Mental Flexibility
Did you ever consider that your brain can flex similarly to the way your biceps can? Sure, brain flexing is more abstract and less literal, but the concept...
FEB 12, 2020
Drug Discovery & Development
FEB 12, 2020
Does Traditional Chinese Medicine Work Against Coronavirus?
Over 45,000 cases of Wuhan Coronavirus have been reported globally, alongside over 1,100 deaths. Although over 4,700 people are said to have recovered from...
Loading Comments...