Is Penicillin Allergy a Risk Factor for Surgical Site Infection After Oral and Maxillofacial Surgery?
| Autor: | Meredith August, Daniel M. Roistacher, Nalton F. Ferraro, Joshua A. Heller |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Allergy
medicine.medical_specialty medicine.drug_class Antibiotics Penicillins Drug Hypersensitivity Risk Factors Internal medicine polycyclic compounds medicine Humans Surgical Wound Infection Risk factor Retrospective Studies business.industry Retrospective cohort study Perioperative Antibiotic Prophylaxis medicine.disease Surgery Oral Anti-Bacterial Agents Penicillin Otorhinolaryngology Cohort Oral and maxillofacial surgery Surgery Oral Surgery business medicine.drug |
| Zdroj: | Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 80(1) |
| ISSN: | 1531-5053 |
| Popis: | The selection of perioperative antibiotics for prevention of surgical site infection (SSI) is often limited by the presence of a reported penicillin allergy. The purpose of this study was to determine if oral and maxillofacial surgery patients who report allergy to penicillin are at an increased risk of developing SSI.A retrospective cohort study was performed of patients who underwent oral and maxillofacial surgical procedures in the operating room setting at a single institution between 2011 and 2018. The following categories of procedures were investigated: dentoalveolar, orthognathic, orthognathic with third molar extraction, pathology and reconstruction, and temporomandibular joint. The primary predictor and outcome variables were reported penicillin allergy and surgical site infection, respectively. Bivariate and multiple logistic regression analysis were performed. P.05 was considered to be significant.The cohort was composed of 2,058 patients of which 318 (15.5%) reported allergy to penicillin. Beta-lactam antibiotics were administered less frequently to penicillin allergic patients perioperatively compared with those without penicillin allergy (7.9 vs 97.1%, P.001), while clindamycin was more commonly administered (76.4 vs 2.5%, P.001). Clindamycin was associated with a higher SSI rate compared with beta-lactam antibiotics (5.6 vs 1.4%, P.001). Penicillin allergy was significantly associated with SSI at an adjusted odds ratio of 2.61 (95% CI 1.51 to 4.49, P = .001). After holding perioperative antibiotic usage equal between the 2 groups, penicillin allergy per se was no longer associated with SSI (P = .901), suggesting that the outcome was mediated by antibiotic selection.Penicillin allergy was associated with development of SSI due to receipt of non-beta-lactam antibiotics as perioperative prophylaxis. Formal allergy evaluation should be considered for patients with putative penicillin allergy. |
| Databáze: | OpenAIRE |
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