Date of Award

Spring 5-5-2023

Document Type

DNP Project

Project Team Faculty Member

Dr. Rebecca Collier

Project Team Faculty Member

Dr. Lauren Douglass


cefazolin, Ancef, penicillin allergy, perioperative antimicrobial prophylaxis, beta-lactam cross-reactivity, SSI prophylaxis


Surgical site infections (SSI) are a type of hospital-acquired infection that are largely preventable. Cefazolin, a first-generation cephalosporin beta-lactam, is the recommended antibiotic for SSI prophylaxis (Bratzler et al., 2013). Approximately 10% of the general population reports a penicillin allergy (Joint Task Force on Practice Parameters et al., 2010). Penicillin is another beta-lactam. Penicillin-allergic patients are commonly prescribed alternative, less effective, antimicrobial agents for SSI prophylaxis, causing suboptimal outcomes. Current literature reports a cross-reactivity potential of less than 2%, with an even lower risk associated with cefazolin (Picard et al., 2019; Sousa-Pinto et al., 2021). This project aimed to review the literature surrounding beta-lactam allergy and cross-reactivity and create an evidence-based cefazolin administration algorithm for anesthesia providers at a tertiary care center in central Illinois. An educational presentation was conducted at the host facility, and participants completed a post-presentation survey to evaluate the algorithm. Implementation of the evidence-based algorithm optimized SSI prophylaxis, potentially improving patient outcomes, and avoiding the negative effects of alternative antibiotic administration.

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