| Title: |
National expert consensus on the management of antibiotic prophylaxis in surgical patients with a penicillin allergy label based on the Delphi method |
| Authors: |
Gouel-Chéron, Aurélie; Neukirch, Catherine; Barbaud, Annick; Dupont, Axelle; Zahar, Jean-Ralph; Kernéis, Solen; Garnier, Marc; Birgand, Gabriel; Romano-Bertrand, Sara; Lesprit, Philippe; Diamantis, Sylvain; Gauzit, Remy; Marcault, Estelle; Leone, Marc; Boisson, Matthieu; Roger, Claire; Dahyot-Fizelier, Claire; Demoly, Pascal; Chiriac, Anca; Montravers, Philippe |
| Contributors: |
Service d'anesthésie - réanimation chirurgicale CHU Bichat; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard Paris; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité); Université Paris Cité (UPCité); Anticorps en thérapie et pathologie - Antibodies in Therapy and Pathology; Institut Pasteur Paris (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité); Service de Pneumologie A Paris; AP-HP - Hôpital Bichat - Claude Bernard Paris; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité); Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP); Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU); Service de biostatistiques et information médicale Saint-Louis; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal Paris; GHU AP-HP Nord - Université Paris Cité; Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Université Clermont Auvergne (UCA); Génétique, Reproduction et Développement (GReD); Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA); Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes); Cibles et Médicaments des Infections et de l'Immunité - UR 1155 (IICiMed); Nantes Université - UFR des Sciences Pharmaceutiques et Biologiques (Nantes Univ - UFR Pharmacie); Nantes Université - pôle Santé; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ); Hydrosciences Montpellier (HSM); Institut de Recherche pour le Développement (IRD)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM); CHU Montpellier = Montpellier University Hospital; Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); CHU de Grenoble-Alpes - Centre Hospitalier Universitaire CHU Grenoble (CHUGA); Centre Hospitalier de Melun (CHM); Dynamic Microbiology - EA 7380 (DYNAMIC); École nationale vétérinaire d'Alfort (ENVA)-Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)-Université Paris-Est (UPE)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); AP-HP - Hôpital Cochin Broca Hôtel Dieu Paris; Service Anesthésie et Réanimation Hôpital Nord - APHM; Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Nord CHU - APHM; Pharmacologie des anti-infectieux et antibiorésistance U 1070 (PHAR2 Poitiers ); Université de Poitiers = University of Poitiers (UP)-Institut National de la Santé et de la Recherche Médicale (INSERM); Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers La Milétrie ); Université de Poitiers – UFR Santé Faculté de Médecine et de Pharmacie (UFR Santé Poitiers ); Université de Poitiers = University of Poitiers (UP); Centre Hospitalier Universitaire de Nîmes (CHU Nîmes); Initial MAnagement and prevention of acute orGan failures IN critically ill patiEnts (IMAGINE); Université de Montpellier (UM); Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM); The study was supported by a grant from the Direction Générale de l'Offre de Soins (DGOS) in France, in the section “Programme de recherche sur la performance du système des soins—PREPS 2021”. |
| Source: |
EISSN: 2632-1823 ; JAC-Antimicrobial Resistance ; https://hal.science/hal-05155192 ; JAC-Antimicrobial Resistance, 2025, 7 (2), pp.dlaf024. ⟨10.1093/jacamr/dlaf024⟩ |
| Publisher Information: |
CCSD; Oxford University Press |
| Publication Year: |
2025 |
| Collection: |
Université de Poitiers: Publications de nos chercheurs.ses (HAL) |
| Subject Terms: |
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases; [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery; [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology |
| Description: |
International audience ; Background: Patients with a penicillin allergy label have an increased risk of surgical site infection. Although a decision tree was published in 2019 to define which patients could benefit from direct cephalosporin use in the perioperative setting, this strategy remains unvalidated. This consensus statement aimed to adapt it based on an expert consensus to cover persisting caveats and to adapt it to an environment with poor allergist resources. Methods: Perioperative antibiotic prophylaxis and allergy experts were invited to participate. The Delphi method was implemented using an online-secured network. The panellists were given 3 weeks to answer each round. A consensus was reached if more than 75% of the experts rated the item ≥ 7 and if less than 25% rated the item ≤ 3. Results: Sixteen experts participated. A high level of agreement was obtained after four rounds, defining four categories of the index reaction: unknown, not compatible, or compatible with an immediate or delayed hypersensitivity reaction. Twelve items were defined to stratify the risk of true penicillin allergy according to the index reaction history. The experts agreed that patients with high-risk reactions could benefit from either an allergy work-up or beta-lactam alternatives use. Those at low risk could benefit from direct cephalosporin administration. Conclusions: This resulted in an adapted decision tree to promote cephalosporin prescription in patients with penicillin allergy labels. It will be used in a stepped-wedge prospective multicentric randomized study to assess its applicability and acceptability to promote first- and second-generation cephalosporin administration in the perioperative period. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/40046066; PUBMED: 40046066; PUBMEDCENTRAL: PMC11880800 |
| DOI: |
10.1093/jacamr/dlaf024 |
| Availability: |
https://hal.science/hal-05155192; https://hal.science/hal-05155192v1/document; https://hal.science/hal-05155192v1/file/dlaf024.pdf; https://doi.org/10.1093/jacamr/dlaf024 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.8809CB3D |
| Database: |
BASE |