Safety of cefazolin for perioperative prophylaxis in patients with penicillin allergy labels

Abstract

Cefazolin is a first-line antibiotic for perioperative prophylaxis of surgical site infections.1 Between 8% and 15% of the US population have penicillin allergy labels (PAL).2 Patients with PAL receive perioperative cefazolin less frequently and are more likely to receive alternative antibiotics, increasing their risk of surgical site infection.1 This practice is likely from overestimating the risk of cross-reactivity between penicillin and cephalosporins. Cross-reactivity among these antibiotics is thought to be from a common R1 side chain, absent in cefazolin.