Penicillin allergy may increase risk of surgical site infection

Roughly 40 percent of healthcare-related infections in hospitalized patients occur at the site of surgical incisions that can lead to complications and death.
By Amy Wallace  |  Oct. 9, 2017 at 12:08 PM
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Oct. 9 (UPI) -- A recent study by Massachusetts General Hospital researchers found that a penicillin allergy may increase the risk of surgical site infections.

The study, published Monday in the journal Clinical Infectious Diseases, found that surgical patients with a penicillin allergy are significantly more likely to develop a surgical site infection compared to patients who were not allergic to penicillin.

Nearly 40 percent of healthcare-related infections in hospitalized patients occur at the site of surgical incisions. Those type of infections can lead to complications and death and average $25,000 in healthcare costs.

Researchers found that the risk of infection was 50 percent higher in patients with a documented penicillin allergy, who previous research showed are probably not really allergic to penicillin.

"This study has direct clinical significance," Dr. Kimberly Blumenthal, of the Division of Rheumatology, Allergy and Immunology, the Medical Practice Evaluation Center and the Lawrence Center for Quality and Safety at MGH, said in a press release. "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."

Researchers reviewed medical records of 8,400 patients who underwent common surgical procedures including hip or knee replacement, coronary artery bypass, colon surgery and hysterectomy at MGH from 2010 to 2014. About 922 patients had penicillin allergy on their medical record.

Roughly 214 patients developed surgical site infections, 3.5 percent of those with a documented penicillin allergy, compared to 2.6 percent of patients without penicillin allergy.

"We hope our findings spark reconsideration of the language about penicillin allergy testing in the national guidelines," said Dr. Erica Shenoy, of the MGH Division of Infectious Disease and the Infection Control Unit. "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."

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