Perioperative medicine & outcomes
Perioperative Penicillin and Cephalosporin Antibiotic Allergy Assessment and Testing: The PREPARE Pilot Randomized Clinical Trial
Authors' conclusion
Low-risk β-lactam AAL were successfully evaluated and delabeled by anesthesiologists in the preoperative clinic using the intervention.
Study context
- Population
- Adults with a reported β-lactam antibiotic allergy label likely to require IV perioperative antibiotic prophylaxis, preoperative anesthesiologist-led clinics at 3 tertiary hospitals in Melbourne, Australiaof 511 eligible
- Participants
- 150 adults
- Comparison
- Intervention vs Control
- Interventionn = 74
- Controln = 76reference
- Primary endpoint
- Feasibility: proportion randomised to intervention receiving it per protocol and proportion of eligible patients consenting; safety: proportion of intervention group with antibiotic-associated AE
- Follow-up
- Within 90 days postsurgery (safety)
Methodological detailsmulticentre, phase 2 feasibility and safety trial, 1:1 randomisation
- Multicentre
- Phase 2 feasibility and safety trial
- 1:1 randomisation
Primary result
As reported in the abstract
Feasibility of recruitment and intervention delivery
Enrolled of eligible patients: 150 of 511
29.4%
95% CI 25.4%–33.5%
Intervention patients who had allergy testing: 47 of 74
63.5%
95% CI 51.5%–74.4%
Low-risk patients proceeding to allergy testing: 28 of 30
93%
Moderate/high-risk patients proceeding to allergy testing: 19 of 44
43%
Further findings
Restricted antibiotic use
Safety
| Outcome | Intervention |
|---|---|
| Antibiotic-related AE (primary safety outcome) · within 90 days postsurgery | 5.4% (95% CI 1.5%–13.3%) |
- Antibiotic-related adverse event (AE) (primary safety outcome) — Immune-mediated events (benign rash), without delay to surgery
- 1
Original publication
Perioperative Penicillin and Cephalosporin Antibiotic Allergy Assessment and Testing: The PREPARE Pilot Randomized Clinical Trial. JAMA Surg. Published 1 May 2025. doi:10.
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