{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T17:12:24Z","timestamp":1786381944832,"version":"build-2736575974"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X25102948_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the impact of reported \u03b2-lactam allergy on the risk of surgical site infections (SSIs), given that most reported cases are unverified and may lead to suboptimal antibiotic prophylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25102948_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25102948_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Four databases were systematically searched for studies reporting SSI rates in patients with and without \u03b2-lactam allergy. The primary outcome was SSI incidence; secondary outcomes included mortality, length of hospital stay (LOS) and adverse events. Subgroup analyses were conducted to explore potential sources of heterogeneity. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Risk of bias was assessed using the ROBINS-I tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25102948_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-five retrospective observational studies comprising 460,284 patients were included. Reported \u03b2-lactam allergy was associated with a significantly increased risk of SSI (RR = 1.55, 95% CI = 1.24\u20131.94). This association remained consistent across sensitivity and subgroup analyses, particularly in studies relying on self-reported allergies. Patients receiving \u03b2-lactam antibiotics had a significantly lower SSI risk than that of patients receiving non-\u03b2-lactam alternatives (RR = 0.63, 95% CI = 0.42\u20130.94). No significant differences were found in LOS or hypersensitivity reaction rates. Mortality was not reported in any of the included studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25102948_as5\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Reported \u03b2-lactam allergy is associated with an increased risk of SSI, highlighting the importance of accurate allergy assessment. Selective administration of \u03b2-lactam agents, such as cefazolin, may offer a safe and effective option for preoperative prophylaxis in patients without a history of severe hypersensitivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2025.10294","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T12:04:30Z","timestamp":1757505870000},"page":"1140-1150","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Consequences of reported \u03b2-lactam allergy on perioperative outcomes: a systematic review and meta-analysis of surgical site infection risk"],"prefix":"10.1017","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4606-7150","authenticated-orcid":false,"given":"Yuki","family":"Hanai","sequence":"first","affiliation":[{"name":"Toho 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World Health Organization. Global guidelines for the prevention of surgical site infection. 2nd ed. 2018. https:\/\/www.who.int\/publications\/i\/item\/9789241550475. Published 2018. 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Japanese Society of Chemotherapy and Japan Society for Surgical Infection. Japanese Clinical Practice Guidelines for antimicrobial prophylaxis in surgery 2016 [in Japanese]. http:\/\/www.gekakansen.jp\/file\/antimicrobial-guideline.pdf. Published 2016. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}