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Comment & Response
August 25, 2021

Dual Allergy to Penicillin and Cefazolin—Does Anaphylaxis Matter?

Author Affiliations
  • 1Department of Anesthesiology and Perioperative Medicine, University of Missouri School of Medicine, Columbia
  • 2Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, Zadar General Hospital, Zadar, Croatia
JAMA Surg. 2021;156(12):1184. doi:10.1001/jamasurg.2021.3760

To the Editor We read with great interest the article by Sousa-Pinto and colleagues1 on cefazolin and penicillin allergies. This is an important topic on administration of preferred antibiotics for prophylaxis of surgical site infection (SSI). The authors reported a meta-analytical frequency of 0.7% for patients with penicillin allergy history and allergy to cefazolin (dual allergy).1 They suggested that most patients with a history of penicillin allergy may safely receive cefazolin, with the exception of patients with confirmed penicillin allergy.1 However, given the low frequency of penicillin-cefazolin dual allergy, determined cefazolin should be administered regardless of penicillin allergy history.1

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