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Background: Cefazolin is the preferred antimicrobial for prevention of surgical-site infections in most procedures at our institution. Our first alternative is vancomycin which is associated with higher adverse events and infection rates. The presence of penicillin allergies can influence prescribing of vancomycin despite a low risk of cross-reactivity between penicillin and cephalosporins. Nebraska Medicine implemented a systemwide change in April 2022 that suppressed alerts for non–IgE-mediated penicillin allergies in the electronic medical record (EMR, Epic Systems) upon cephalosporin prescribing. We evaluated changes in perioperative antimicrobial surgical infection prophylaxis after this change. Methods: We conducted a quasi-experimental study of all patients undergoing procedures for which cefazolin is considered preferred per institutional guidance. Preintervention data were from April 1, 2021, to March 31, 2022, and postintervention data included patients from April 11, 2022, to October 31, 2022, after guidance was distributed to surgeons, operating room staff, and pharmacists. Patients were excluded if they were aged |
