{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T21:18:15Z","timestamp":1783027095292,"version":"3.54.6"},"reference-count":34,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"\n BACKGROUND AND OBJECTIVES<\/jats:title>\n Cefazolin, a first-generation cephalosporin, is the most commonly recommended antibiotic for perioperative prophylaxis to reduce surgical site infections. Children with a reported penicillin allergy often receive an alternative antibiotic because of a common misunderstanding of the cross-reactivity between these antibiotics. This use of alternative antibiotics in surgical populations have been associated with increased infections, antibiotic resistance, and health care costs. We aimed to increase the percentage of patients with nonsevere penicillin-class allergies who receive cefazolin for antibiotic prophylaxis.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A multidisciplinary team conducted this quality improvement initiative, with a series of 3 plan-do-study-act cycles aimed at children with nonsevere penicillin-class allergies undergoing surgical procedures that require antibiotic prophylaxis. The primary outcome measure was the percentage of surgical encounters among patients with nonsevere penicillin-class allergies who received cefazolin as antibiotic prophylaxis. Statistical process control charts were used to measure improvement over time.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Approximately 400 children were involved in this project. There was special cause variation and a shift in the center line from 60% to 80% of eligible patients receiving cefazolin for antibiotic prophylaxis, which was sustained for the duration of the project. In the last month, 90% of eligible patient received cefazolin, surpassing our goal of 85%. This improvement has been sustained in the 5 months after project completion. We had no cases of severe allergic reactions in the operating room.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Our multidisciplinary education-focused interventions were associated with a significant increase in the use of cefazolin for perioperative antibiotic prophylaxis in patient with penicillin allergies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2021-050694","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T08:09:52Z","timestamp":1643875792000},"source":"Crossref","is-referenced-by-count":16,"title":["Increasing Cefazolin Use for Perioperative Antibiotic Prophylaxis in Penicillin-Allergic Children"],"prefix":"10.1542","volume":"149","author":[{"given":"Rebecca S.","family":"Isserman","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine"},{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jazreel","family":"Cheung","sequence":"additional","affiliation":[{"name":"Center for Healthcare Quality and Analytics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domonique","family":"Varallo","sequence":"additional","affiliation":[{"name":"Center for Healthcare Quality and Analytics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Cafone","sequence":"additional","affiliation":[{"name":"Divisions of Allergy and Immunology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhee","family":"Lee","sequence":"additional","affiliation":[{"name":"Divisions of Allergy and Immunology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Chiotos","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine"},{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"},{"name":"Infectious Diseases, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wallis T.","family":"Muhly","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine"},{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talene A.","family":"Metjian","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Swami","sequence":"additional","affiliation":[{"name":"University of Pennsylvania 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