Ancef to PCN allergic patient

[gasknight]

For a patient with a convincing PCN allergy, though not anaphylaxis, can you still give cefazolin? I've read the estimated cross reactivity between PCN and first gen cephalosporins is ~ 2-7% (and probably even lower for non-IgE mediated allergies), so what's the common pre-incision antibiotic choice for this patient?

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[GaseousClay]

if its just a rash i still give ancef slower than usual. if severe allergy then clindamycin

 

[gotname]

For a patient with a convincing PCN allergy, though not anaphylaxis, can you still give cefazolin? I've read the estimated cross reactivity between PCN and first gen cephalosporins is ~ 2-7% (and probably even lower for non-IgE mediated allergies), so what's the common pre-incision antibiotic choice for this patient?

I had surgery Monday and it took ages to find one - they eventually gave me clindamycin. No problems.

 

[OB1🤙]

The allergenic side chains on ancef and pcn are completely different.

You absolutely can give ancef to any vague pcn allergy.

You probably could even give it to true pcn anaphylaxis, if you had the cojones.

We give way, way way too much clinda to "pen allergic" patients.

Great A&A review of all things antibiotic-
http://mobile.journals.lww.com/anes...ewer.aspx?year=2015&issue=04000&article=00027

 

[OB1🤙]

And for long cases, we should be running ancef drips.

http://mobile.journals.lww.com/anes...ewer.aspx?year=2015&issue=04000&article=00005

 

[gasknight]

The allergenic side chains on ancef and pcn are completely different.

You absolutely can give ancef to any vague pcn allergy.

You probably could even give it to true pcn anaphylaxis, if you had the cojones.

We give way, way way too much clinda to "pen allergic" patients.

Great A&A review of all things antibiotic-
http://mobile.journals.lww.com/anes...ewer.aspx?year=2015&issue=04000&article=00027

Very helpful, thank you.

 

[Ronin786]

Early studies that showed cross-reactivity between PCNs and cephalosporins used cephalosporins that were contaminated with PCN spores. Anything short of clear histamine release secondary to PCN administration in the history (anaphylaxis, hives) shouldn't preclude the use of cephalosporins. That said, anybody with any sort of PCN allergy seems to get clinda.

 

[deleted59964]

Periopdoc knows his stuff


http://forums.studentdoctor.net/threads/pcn-allergy-and-keflex.1121562/