{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T17:52:45Z","timestamp":1782237165357,"version":"3.54.5"},"reference-count":46,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate recent studies assessing the safety of cefazolin for surgical site infection (SSI) prophylaxis in patients with reported \u03b2-lactam allergies and to review interventions aimed at optimizing its use in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Decades of clinical practice have been shaped by misleading assumptions regarding the degree of cross-reactivity between penicillins and cephalosporins. Contemporary evidence demonstrates that cefazolin, a first-generation cephalosporin with a unique R1 side chain, is not cross-reactive with penicillins and is well tolerated in patients with histories of immediate and severe delayed hypersensitivity reactions. Retrospective and prospective studies consistently report low rates of cefazolin-associated hypersensitivity reactions, including in cohorts with high-risk allergy histories. In contrast, alternative agents such as clindamycin and vancomycin are associated with higher rates of SSI and adverse effects. Institutional interventions, including educational initiatives, protocol-based antibiotic selection, and R1 side chain\u2013based algorithms, have successfully increased cefazolin utilization without increasing the incidence of hypersensitivity events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cefazolin is a safe and effective agent for SSI prophylaxis and should be used in patients with \u03b2-lactam allergies. Overcoming persistent misconceptions and adopting evidence-based prescribing strategies can reduce unnecessary avoidance of cefazolin, decrease postoperative infection rates, and improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajhp\/zxag138","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:48:42Z","timestamp":1781869722000},"source":"Crossref","is-referenced-by-count":0,"title":["Cefazolin for all or just some? A review of cefazolin for surgical site infection prophylaxis in patients with \u03b2-lactam allergies"],"prefix":"10.1093","author":[{"given":"Meghan N","family":"Jeffres","sequence":"first","affiliation":[{"name":"University of Colorado Skaggs School of Pharmacy, University of Colorado Anschutz Medical Campus , Aurora, CO ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"issue":"5 Pt 1","key":"2026062313401747000_zxag138-B1","doi-asserted-by":"crossref","first-page":"650","DOI":"10.7326\/0003-4819-89-5-650","article-title":"Cefazolin","volume":"89","author":"Quintiliani","year":"1978","journal-title":"Ann Intern Med"},{"issue":"4","key":"2026062313401747000_zxag138-B2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.7164\/antibiotics.23.195","article-title":"Cefazolin, a new semisynthetic cephalosporin antibiotic. IV. 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