Penicillin Allergy

  • Cefazolin is the recommended antibiotic for surgical prophylaxis and can be used safely in the majority of patients with penicillin allergy, including anaphylaxis¹
  • Cefazolin has unique side chains unlike any currently marketed penicillins or cephalosporins, making cross-reactivity highly unlikely. Anaphylaxis to cefazolin is uncommon, occurring in 0.0006% of surgical patients² ³
  • Alternative pre-operative antibiotic regimens are associated with increased surgical site infections and adverse effects compared to cefazolin⁴ ⁵
  • Only patients with a history of anaphylactic reaction to cefazolin or a history of Stevens-Johnson Syndrome or other severe, delayed reaction to beta-lactams should use alternative agents

  1. Novalbos A, Sastre J,Cuesta J, De Las Heras M, Lluch-Bernal A, Bombin C et al. Lack of allergic cross-reactivity to the cephalsoproins among patient allergic to penicilins. Clin Exp Allergy 2001; 31: 438-443
  2. Pichichero ME, Zagursky R. Penicillin and cephalosporin allergy. Ann Allergy Asthma Immunol 2014;112: 404-412
  3. Gurieri C, Weingarten TN, Martin DP, Babovic N, Nar BJ, Sprung J et al. Allergic reactions during anesthesia at a large United States referral center. Anesth Analg 2011; 113: 1202-12
  4. Blumenthal KG, Ryan E, Li Y, Kuhlen JL, Shenoy ES. The impact of reported penicillin allergy on surgical site infection risk. Clin Infect Dis 2018; 66: 329-336
  5. Eric Macy, MD, MS,a and Richard Contreras, MS. Health care use and serious infection prevalence associated with penicillin "allergy" in hospitalized patients: A cohort study. J Allergy Clin Immunol. 2014;133(3):790-6