Risk Of Allergy Research Articles

The effects of meteorological conditions on allergenic airborne pollen in arid Northwest China

Understanding the variations in temporal allergenic airborne pollen (AAP) distribution and the mechanisms of pollen release and dispersal during pollen season is fundamental for predicting respiratory allergies, as well as assessing the effects of meteorological conditions on vegetation. In this paper, we described the seasonal variations of in situ AAP for dominant taxa in samples obtained from 11 May 2019 to 31 March 2022, with uninterrupted quasi-monthly sampling time intervals (22–48 days). We also discussed how meteorological factors drive pollen variations in an arid region of Northwest China through correlation analysis and the HYSPLIT model. Results showed: (1) The three most prevalent AAP taxa were Artemisia (65.1% by average), Amaranthaceae (13.5% by average), and Poaceae (6.5% by average), with a high cumulative pollen concentration (CPC) value during July–September period. (2) The duration and total CPC in pollen season were shorter and lower in 2020 than that in 2019 and 2021, which were attributed to the lower precipitation and higher temperature from July to September 2020. In contrast, the wind was the dominant factor influencing each sample's CPC in the non-pollen season. (3) Both the predominant potential source area (PSA) and short transport pathways suggested AAP mainly comes from the local and regional areas. (4) There would be a serious risk of allergy to the three AAP types, especially Artemisia. Our results reveal that precipitation and temperature during July–September have an immediate effect on the characteristics of the AAP pollen season in arid regions.

The Quality and Management of Penicillin Allergy Labels in Pediatric Primary Care.

Penicillin allergy labels are the most common drug allergy label. The objective of this study was to describe the quality and management of penicillin allergy labels in the pediatric primary care setting. Retrospective chart review of 500 of 18 015 children with penicillin allergy labels born from January 1, 2010 to June 30, 2020 randomly selected from an outpatient birth cohort from Texas Children's Pediatrics and Children's Hospital of Philadelphia networks. Penicillin allergy risk classification ("not allergy," "low risk," "moderate or high risk," "severe risk," "unable to classify") was determined based on documentation within (1) the allergy tab and (2) electronic healthcare notes. Outcomes of allergy referrals and penicillin re-exposure were noted. Half of penicillin allergy labels were "unable to classify" based on allergy tab documentation. Risk classification agreement between allergy tabs and healthcare notes was fair (Cohen's ĸ = 0.35 ± 0.02). Primary care physicians referred 84 of 500 (16.8%) children to an allergist, but only 54 (10.8%) were seen in allergy clinic. All children who were challenged (25 of 25) passed skin testing. Removal of allergy labels was uncommon (69 of 500, 13.8%) but occurred more often following allergy appointments (26 of 54, 48%) than not (43 of 446, 9.6%, P < .001). Children delabeled by primary care physicians were as likely to tolerate subsequent penicillin-class antibiotics as those delabeled by an allergist (94% vs 93%, P = .87). Penicillin allergy documentation within the allergy tab was uninformative, and children were infrequently referred to allergists. Future quality improvement studies should improve penicillin allergy documentation and expand access to allergy services.

Effects of timing of complementary food introduction on childhood food allergy development: A modified role of ambient air pollution exposure

BackgroundFood allergy increased in the recent years causing heavy disease burden worldwide, yet the unique factors for the second-wave allergy epidemic since a rise of allergic diseases are unclear. ObjectiveTo examine the impact of introduction timing of complementary foods on childhood food allergy and whether ambient air pollution modify this association. MethodsA retrospective cohort study of 2,598 preschoolers was conducted at 36 kindergartens at Changsha of China during 2011–2012. A standard questionnaire was developed to survey each preschooler's introduction timing of complementary foods, food allergy, and home environments. Each subject's exposure to ambient air pollutants including PM10, SO2, and NO2 was estimated for pregnancy and postnatal period. Association between food allergy and introduction timing of complementary foods as well as its modification by ambient pollution were evaluated by multiple logistic regression model. ResultsChildhood total food allergy (14.6%) was significantly positively associated with early introduction to fruit or vegetable before 3 months with OR = 1.97 (1.25–3.11), especially for egg and milk allergies. Food allergy was also significantly associated with NO2 exposure in pregnancy especially during the 1st trimester with ORs (95% CI) = 1.24 (1.00–1.54) and 1.27 (1.03–1.58) and postnatal period with OR of 1.30 (1.01–1.66) respectively for per IQR increase in their exposure. We observed that living near traffic-main road and other areas significantly increased food allergy risk of early introduction of fruit and vegetable. We further detected that early introduction of milk powder or porridge significantly decreased the risk of food allergy at the condition of light outdoor air pollution exposure during postnatal period. Sensitivity analysis showed that children living at urban area, male sex, younger age, and having breast-feeding were more susceptible to the effect of early introduction of fruit and vegetable on food allergy. ConclusionOur study indicates that the role of introduction timing of complementary foods on food allergy could be adjusted by air pollution exposure level, which may partly explain the second-wave allergy epidemic and provide a potential preventive strategy.

Diet-associated vertically transferred metabolites and risk of asthma, allergy, eczema, and infections in early childhood.

Evidence suggests maternal pregnancy dietary intake and nutrition in the early postnatal period to be of importance for the newborn child's health. However, studies investigating diet-related metabolites transferred from mother to child on disease risk in childhood are lacking. We sought to investigate the influence of vertically transferred metabolites on risk of atopic diseases and infections during preschool age. In the Danish population-based COPSAC2010 mother-child cohort, information on 10 diet-related vertically transferred metabolites from metabolomics profiles of dried blood spots (DBS) at age 2-3 days was analyzed in relation to the risk of childhood asthma, allergy, eczema, and infections using principal component and single metabolite analyses. In 678 children with DBS measurements, a coffee-related metabolite profile reflected by principal component 1 was inversely associated with risk of asthma (odds ratio (95% CI) 0.78 (0.64; 0.95), p=.014) and eczema at age 6 years (0.79 (0.65; 0.97), p=.022). Furthermore, increasing stachydrine (fruit-related), 3-carboxy-4-methyl-5-propyl-2-furanpropanoate (fish-related), and ergothioneine (fruit-, green vegetables-, and fish-related) levels were all significantly associated with reduced risks of infections at age 0-3 years (p < .05). This study demonstrates associations between pregnancy diet-related vertically transferred metabolites measured in children in early life and risk of atopic diseases and infections in childhood. The specific metabolites associated with a reduced disease risk in children may contribute to the characterization of a healthy nutritional profile in pregnancy using a metabolomics-based unbiased tool for predicting childhood health.

The Gut Microbiome of Infants Who Were Exposed in Utero to Hurricane Maria in Puerto Rico

Due to climate change, extreme weather events have been more frequent and intense. Prenatal exposure to disasters is strongly associated with increased risks of chronic diseases, including asthma and allergies. Although the gut microbiota in early life has been suggested as a mechanism underlying this phenomenon, the gut microbiome of infants who are exposed in utero to an extreme weather event has not been characterized.

Evaluation of Testing and Diagnosis of Tree Nut Allergy in Infants Undergoing Screening for Peanut Allergy

Current guidelines recommend early introduction of peanuts (PN) to all infants with an option of performing screening testing before introduction in those at highest risk for PN allergy. Specific guidelines on screening for tree nut (TN) allergy prior to introduction do not exist and the rate of PN/TN co-sensitization and allergy in this population is not known.

Implementation of a Nurse-Driven Penicillin Allergy Risk Score in the Pre-Operative Setting Increases Cefazolin Use Perioperatively.

Numerous quality improvement initiatives have improved cefazolin use in penicillin-allergic surgical patients, but often rely on access to Allergy specialty services, limiting their generalizability. We aimed to characterize and assess the efficacy of a nurse-driven, conservative penicillin allergy risk-stratification tool that can be used in resource-poor settings.

A Cross Sectional Study of Respiratory and Allergy Status in Dairy Workers

ABSTRACT Introduction Workers on dairy farms face exposures to organic dusts and endotoxin. At the same time, a number of studies of farmers have reported a lower prevalence of asthma in farmworkers compared to persons without farm contact. The “hygiene hypothesis” suggests that early life exposures on farms could be protective against allergic disease and asthma. Such protective relationships are less well studied in adult farm workers. Methods A cross-sectional analysis of respiratory function and allergy status was performed in a sample of dairy farm workers (n = 42) and community controls (n = 40). Measures of respiratory status (spirometry, exhaled nitric oxide FeNO, self-reported symptoms) and levels of total and bovine-specific IgE were compared between the groups. Results Prevalence of self-reported asthma and most respiratory symptoms was similar in the two groups, with the exception of increased report of dyspnea among dairy workers. In the dairy workers, level of lung function was not reduced and FeNO was not increased. In unadjusted and adjusted models, dairy work was not associated with reduced lung function or increased airway inflammation. Mean IgE levels did not differ significantly between workers and controls, but elevated bovine-specific IgE was detected only among dairy workers, with an apparent association between elevated bovine IgE and increased FeNO. Conclusion While dairy workers did not demonstrate increased asthma prevalence compared to controls, sensitization to bovine antigen in several workers appeared to be associated with airway inflammation. Occupational health programs for dairy workers should consider the risk of animal allergy as part of respiratory health protection efforts.

The prevalence of food allergy in cesarean-born children aged 0-3years: A systematic review and meta-analysis of cohort studies.

Previous studies reported a higher risk of food allergy for cesarean-born children than vaginal-born children. This study aims to systematically compare the prevalence of food allergy among cesarean-born and vaginal-born children aged 0-3years. Three English and two Chinese databases were searched using terms related to food allergies and cesarean sections. Cohort studies that reported the prevalence of food allergy in cesarean-born and vaginal-born children aged 0-3years were included. Two reviewers performed study selection, quality assessment, and data extraction. The pooled prevalence of food allergy in cesarean-born and vaginal-born children was compared by meta-analysis. Nine eligible studies, with 9,650 cesarean-born children and 20,418 vaginal-born children aged 0-3years, were included. Of them, 645 cesarean-born children and 991 vaginal-born children were identified as having food allergies. The pooled prevalence of food allergy was higher in cesarean-born children (7.8%) than in vaginal-born children (5.9%). Cesarean section was associated with an increased risk of food allergy [odds ratio (OR): 1.45; 95% confidence interval (CI): 1.03-2.05] and cow's milk allergy (OR: 3.31; 95% CI: 1.98-5.53). Additionally, cesarean-born children with a parental history of allergy had an increased risk of food allergy (OR: 2.60; 95% CI: 1.28-5.27). This study suggests that cesarean sections was associated with an increased risk of food and cow's milk allergies in children aged 0-3years. Cesarean-born children with a parental history of allergy demonstrated a higher risk for food allergy than did vaginal-born children. These results indicate that caregivers should be aware of the risks of food allergies in cesarean-born children, reducing the risk of potentially fatal allergic events. Further research is needed to identify the specific factors affecting food allergies in young children. http://www.crd.york.ac.uk/prospero, identifier: International Prospective Register of Systematic Reviews (NO. CRD42019140748).

Maternal prebiotic supplementation impacts colitis development in offspring mice.

Maternal diet plays a key role in preventing or contributing to the development of chronic diseases, such as obesity, allergy, and brain disorders. Supplementation of maternal diet with prebiotics has been shown to reduce the risk of food allergies and affect the intestinal permeability in offspring later in life. However, its role in modulating the development of other intestinal disorders, such as colitis, remains unknown. Therefore, we investigated the effects of prebiotic supplementation in pregnant mice on the occurrence of colitis in their offspring. Offspring from mothers, who were administered prebiotic galacto-oligosaccharides and inulin during gestation or fed a control diet, were subjected to three cycles of dextran sulphate sodium (DSS) treatment to induce chronic colitis, and their intestinal function and disease activity were evaluated. Colonic remodelling, gut microbiota composition, and lipidomic and transcriptomic profiles were also assessed. DSS-treated offspring from prebiotic-fed mothers presented a higher disease score, increased weight loss, and increased faecal humidity than those from standard diet-fed mothers. DSS-treated offspring from prebiotic-fed mothers also showed increased number of colonic mucosal lymphocytes and macrophages than the control group, associated with the increased colonic concentrations of resolvin D5, protectin DX, and 14-hydroxydocosahexaenoic acid, and modulation of colonic gene expression. In addition, maternal prebiotic supplementation induced an overabundance of eight bacterial families and a decrease in the butyrate caecal concentration in DSS-treated offspring. Maternal prebiotic exposure modified the microbiota composition and function, lipid content, and transcriptome of the colon of the offspring. These modifications did not protect against colitis, but rather sensitised the mice to colitis development.

Профилактика пищевой аллергии: современные тенденции

An elimination diet is one of the main measures to prevent flares of different food allergies. Primary prophylaxis of food allergies aims to form tolerance and prevent sensitization to food allergens in infants prone to allergies. Pediatric recommendations for the prevention of food allergies based on elimination diets with conventional formulas replaced by hydrolyzed formulas have been revised in the last decade. Currently, the exclusion of food allergens from the mother's diet, as well as administration of vitamins, prebiotics, probiotics, or synbiotics during pregnancy and breastfeeding are not recommended to prevent food allergies in infants. The age between 4 and 6 months is believed to be optimal for introducing complementary foods. It is still not recommended to use soy formula in infants under 6 months of age and use cow milk-based formulas in infants with a risk of allergy during their first week of life. There are no recommendations on any specific formulas to prevent allergy: it is possible to use both hydrolyzed and conventional formulas. Among the latter, goat milk-based formulas have a number of advantages. The assessment of the preventive effect of goat milk-based formulas, and particularly those containing the 2'-FL oligosaccharide, is undoubtedly promising. Key words: infants, allergy, allergy prevention, food allergy, goat milk, 2'-FL oligosaccharide

Allergology: what's new in 2022

The study of reactions to SARS-CoV-2 vaccines has marked a large part of the literature in the last two years, using the basophil activation test (BAT) as a potential diagnostic tool for reactions to Covid-19 vaccines. In allergic rhinoconjunctivitis, lirentelimab (a humanised monoclonal antibody against lectin 8), reduces patients' symptoms and atopic comorbidities. In severe asthma, tezepelumab (human monoclonal antibody) reduces the annual asthma exacerbation rate over 52 weeks. In terms of diet, the new EAACI guidelines recommend avoiding cow's milk supplementation in infants during the first three days of life to reduce the risk of cow's milk allergy.

Beta-lactam comprehensive allergy management program in a community medical center.

The Beta-lactam Comprehensive Allergy Management Program (CAMP) was implemented to facilitate complete beta-lactam allergy history documentation in the electronic medical record (EMR) and increase beta-lactam utilization. The study objective was to assess the rate of complete allergy histories and days of antimicrobial therapy (DOT) before versus after CAMP implementation. Quasi-experimental study with interrupted time-series analysis. Non-teaching, urban, and community medical center within a multi-hospital health system. Adult inpatients with a beta-lactam allergy receiving antimicrobial therapy. The multidisciplinary CAMP team screened, interviewed, and collected allergy history details of adult inpatients with a beta-lactam allergy receiving antimicrobial therapy starting January 4, 2021. Patients were stratified as high, moderate, or low risk of IgE-mediated allergy and referred to an allergist for skin testing or drug challenge. The EMR was updated with interview details and drug challenge or skin test results. The primary endpoint was rate of complete allergy history documentation before (12/1/18-4/1/19) compared to after (1/4/21-5/1/21) program implementation. The secondary endpoint was days of inpatient beta-lactam therapy. Implementation logistics, de-labeling rate, and antimicrobial therapy changes were evaluated. The program evaluated 392 individuals, with 184 and 208 patients comprising the pre- and post-intervention groups, respectively. The post-intervention period was associated with an increase of 19.8% in complete allergy histories (0.359 PPc; R 2 0.26; p = 0.002) and 9.34 beta-lactam DOT per 1,000-days-present (1.106 PPc; R 2 0.194; p = 0.009). Implementation of a comprehensive beta-lactam allergy management program was associated with higher rates of complete beta-lactam allergy history and beta-lactam use.

Allergy evaluation in syphilis positive pregnant individuals with penicillin allergy: A cost effectiveness analysis

U.S. syphilis rates and vertical transmission have been increasing since 2001. The only treatment for syphilis in pregnancy is penicillin G (PCN). For those with a PCN allergy, no alternate antibiotics are effective, and they are recommended to be evaluated, desensitized if needed, and treated with PCN. Patients can either undergo allergy evaluation and risk stratification, or be directly desensitized at obstetric point of care. In this study, we evaluated allergy evaluation for PCN-allergic, syphilis-positive pregnant individuals as a means to prevent potential anaphylaxis with PCN exposure.

Intake of allergenic foods at 1.5 years and 3 years of age in a general child population in Japan: a cross-sectional study

Recent studies indicate that the timing of introduction of potentially allergenic food is crucial for the development of food allergy in children. This cross-sectional study aimed to clarify the reality of allergen food intake in a general population of young children in Japan. A questionnaire survey of caregivers was conducted at health checkups for 1.5-year (18-month)-old and 3-year-old children in the fall of 2020. The caregivers were asked about (1) the presence/absence of allergic disease symptoms based on the ISAAC questionnaire, and (2) foods that caregivers avoided giving their children. Ordinal logistic regression analyses were periformed to determine factors associated with food avoidance. Questionnaires were distributed to 1720 caregivers, and 1603 (93%) responded. The responders consisted of 771 and 832 caregivers who participated in 1.5-year-old and 3-year-old checkups, respectively. The prevalence of allergic diseases was comparable to recent epidemiological studies in Japan, indicating that the population may be representative. At 1.5 years old, more than 50% of the children were not exposed to peanuts, tree nuts, fish eggs, shellfish, and buckwheat. At 3 years old, the avoidance rates of the foods had decreased but were still between 18.8% and 32.0%. On the other hand, the avoidance rates of chicken egg and cow's milk, the top 2 common allergenic foods in Japan, were much lower at 2.8% and 1.5% at 1.5 years, and they decreased to 1.4% and 0.7% at 3 years old, respectively. Ordinal logistic analysis showed that avoidance of chicken egg, cow's milk, and wheat was associated with food allergy diagnosis and chicken egg avoidance with eczema, but avoidance of other foods showed no associations with any risk factors for food allergy. Caregivers avoided giving various foods, independent of allergy risk factors, to their young children. Since delayed introduction of an allergenic food has been reported to increase the risk of developing an allergy to the food, the results warrant future investigation of the development of food allergies in relation to current eating habits and recommendations.

Are Some Metals in Tattoo Inks Harmful to Health? An Analytical Approach.

Tattoo application is widely performed all over the world; however, injection of coloring substances into the skin as metals may pose a risk for allergies and other skin inflammations and systemic diseases. In this context, tattoo inks in green, black, and red colors of three brands were purchased. Before starting the analysis, the acid mixture suitable for microwave burning was determined, and according to these results, the inks were digested with nitric acid, hydrochloric acid, and hydrofluoric acid. Then, method validation was performed for tattoo inks using inductively coupled plasma-mass spectrometry. The relative contribution of metals to the tattoo ink composition was highly variable between colors and brands. Elements found in the main components of inks are as follows (in mg kg-1): Al, 1191.1-3424.9; Co, 0.04-1.07; Cu, 1.24-2523.4; Fe, 16.98-318.42; Ni, 0.63-17.53; and Zn, 2.6-46.9. It has been determined by the Environmental Protection Agency that in some products, especially the copper element is above the determined limit. The analysis results obtained were classified by chemometric analysis, and the color and brand relationship were determined. More toxicological studies are necessary to understand the effects of tattoo inks containing heavy metals and/or organic components.

Frequency of Infant Egg Consumption and Risk of Maternal-Reported Egg Allergy at 6 Years

BackgroundRecent research suggests that early egg introduction during infancy may help to prevent egg allergy development. However, the infant egg consumption frequency that is sufficient to induce this immune tolerance remains uncertain. ObjectivesWe examined the associations between the infant egg consumption frequency and maternal-reported child egg allergy at 6 y. MethodsWe analyzed data of 1252 children from the Infant Feeding Practices Study II (2005–2012). Mothers reported the frequency of infant egg consumption at 2, 3, 4, 5, 6, 7, 9, 10, and 12 mo old. Mothers reported the status of their child’s egg allergy at the 6-y follow-up. We used Fisher exact test, Cochran–Armitage Trend Test, and log Poisson regression models to compare 6-y egg allergy risk by the frequency of infant egg consumption. ResultsThe risk of maternal-reported egg allergy at 6 y significantly (P-trend = 0.004) decreased with infant egg consumption frequency at 12 mo: 2.05% (11/537) for infants not consuming eggs, 0.41% (1/244) for those consuming eggs <2 times per wk, and 0.21% (1/471) for those consuming eggs ≥2 times per wk. A similar but nonsignificant trend (P-trend=0.109) was observed for egg consumption at 10 mo (1.25%, 0.85%, and 0%, respectively). After adjusting for socioeconomic confounders, breastfeeding, complementary food introduction, and infant eczema, infants who consumed eggs ≥2 times per wk at 12 mo had a significantly lower RR of maternal-reported egg allergy at 6 y (confounder-adjusted RR: 0.11; 95% CI: 0.01, 0.88; P = 0.038), whereas those who consumed <2 times per wk (confounder-adjusted RR: 0.21; 95% CI: 0.03, 1.67; P = 0.141) did not have a significantly lower risk than those who did not consume eggs at all. ConclusionsConsumption of eggs ≥2 times per wk in late infancy is associated with a reduced risk of developing egg allergy later in childhood.

Reported Cases and Diagnostics of Occupational Insect Allergy: A Systematic Review.

A significant part of adult-onset asthma is caused by occupational exposure to both high- and low-molecular-mass agents. Insects are occasionally described to cause occupational allergy in professions including anglers and fishers, laboratory workers, employees of aquaculture companies, farmers, bakers, sericulture workers and pet shop workers. Occupational insect allergies are often respiratory, causing asthma or rhinoconjunctivitis, but can be cutaneous as well. The European Union recently approved three insect species for human consumption, enabling an industry to develop where more employees could be exposed to insect products. This review overviews knowledge on occupational insect allergy risks and the tools used to diagnose employees. Despite the limited availability of commercial occupational insect allergy diagnostics, 60.9% of 164 included reports used skin prick tests and 63.4% of reports used specific IgE tests. In 21.9% of reports, a more elaborate diagnosis of occupational asthma was made by specific inhalation challenges or peak expiratory flow measurements at the workplace. In some work environments, 57% of employees were sensitized, and no less than 60% of employees reported work-related symptoms. Further development and optimization of specific diagnostics, together with strong primary prevention, may be vital to the health conditions of workers in the developing insect industry.

Effect of artificial sweetener saccharin on lysozyme aggregation: A combined spectroscopic and in silico approach

The use of saccharin in food products attracts much attention as it involves the risk of lethal allergies and many protein aggregation diseases. However, its role in protein aggregation has not been explored to date. This study embodies the effect of artificial sweeteners on HEWL in the absence and presence of commonly available natural products such as curcumin and EGCG. Various techniques have been used to characterize the protein interaction, such as steady-state emission and time-resolved fluorescence, FTIR, gel electrophoresis, TEM, and molecular docking. Steady-state and time-resolved studies revealed the binding strength and concomitant effect of saccharin on HEWL protein. Kinetic measurements revealed that saccharin causes significant enhancement of HEWL aggregation with a considerable reduction in lag phase time i.e. from 37 hr to 08 hr. Whereas in the presence of natural products, the effect of saccharin on HEWL aggregation was significantly reduced specifically in the case of curcumin. The result obtained in the fluorescence experiment were also supported by the gel electrophoresis technique and morphological images taken by TEM. The rapid change in the secondary structure of the protein in the presence of saccharin was confirmed by the FTIR spectroscopy technique. This study is instrumental in understanding the effect of saccharin on protein aggregation and the role of commonly available natural products in curbing its effect.

1764. Accuracy of Penicillin Allergy Risk Severity Documentation in Surgical Patients

Abstract Background Clinical guidelines for antimicrobial prophylaxis recommend use of cefazolin for most surgical procedures. Patients who are labeled penicillin (PCN) allergic are often prescribed second line agents, though cross-reactivity is less than 1%. PCN allergic patients have significantly higher rates of readmissions and healthcare-associated infections. Allergy documentation in the medical record is often incomplete or inaccurate, and many allergies can be de-labeled through history alone. Our study aimed to investigate accuracy of allergy risk assessment in PCN allergic patients and the impact on surgical antibiotic prophylaxis for quality improvement. Methods This was a retrospective observational cohort study among adult patients with a reported PCN allergy who underwent a surgical procedure from 3/2019-2/2020 at a single academic institution. The primary outcome was incidence of appropriate documentation of allergy risk severity. Secondary outcomes included receipt of beta-lactam for surgical prophylaxis and incidence of documentation to reflect tolerance. Allergy risk classification was considered appropriate if it aligned with institutional guidelines (Table 1). Results Of 2647 patients who underwent surgical procedures, 330 (12%) reported PCN allergy. Allergy risk severity was appropriately documented in 136 (41%) patients. 150 (45%) were mislabeled as “high” or “unknown” risk compared to reported reaction. 191 (58%) patients with reported PCN allergies received beta-lactam antibiotics peri-operatively. Allergy history had been updated to reflect tolerance in only 6% of patients who received cefazolin for surgical prophylaxis and in 21% who had received beta-lactams previously (Table 2). Table 2:Primary and Secondary Outcomes Conclusion Inaccurate documentation of allergy risk results in decreased first-line antimicrobial use in patients with reported PCN allergies. Documented PCN allergy risk severity was often incorrect and over 100 additional patients could have been labeled “low risk” based on reported reaction. 72% of patients could have received first-line beta-lactam prophylaxis per institutional guidelines. Interventions targeting allergy history documentation alone could positively impact antibiotic selection. Disclosures All Authors: No reported disclosures.