Perioperative medicine & outcomes
A nurse-driven penicillin allergy risk score in the preoperative setting was associated with increased cefazolin use perioperatively
Authors' conclusion
A simple penicillin allergy risk stratification tool implemented in the preoperative setting was associated with increased use of cefazolin and decreased rates of second-line agents post implementation.
Study context
- Population
- Adult penicillin-allergic surgical patients undergoing procedures for which cefazolin is indicated, tertiary care center670 attendants · 1371 non-attendants
- Participants
- 451 / 219 / 1,371
- Comparison
- Post- vs pre-intervention (nurse-driven penicillin allergy risk stratification questionnaire) in Perioperative Care Clinic (PCC) attendants; PCC non-attendants as comparison
- Pre-interventionn = 451reference
- Post-interventionn = 219
- PCC non-attendantsn = 1,371
- Outcome
- Antibiotic use in PCC attendants, post- vs pre-intervention
Methodological detailspre-post intervention, statistical process control charts, multivariable logistic regression
- Pre-post intervention
- Statistical process control charts
- Multivariable logistic regression
Main finding
As reported in the abstract
Each group vs pre-interventionEstimate (95% CI)P value
Post-intervention
aOR (cefazolin use) 1.67(1.09–2.57)
P = 0.019Post-intervention
aOR (clindamycin use) 0.61(0.42–0.89)
P = 0.010Post-intervention
aOR (vancomycin use) 0.56(0.35–0.88)
P = 0.013Safety
- No increase in perioperative anaphylaxis post-intervention
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
A nurse-driven penicillin allergy risk score in the preoperative setting was associated with increased cefazolin use perioperatively. J Clin Anesth. Published 13 March 2024. doi:10.
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